Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial.
Saundra S. Buys,Edward E. Partridge,Amanda Black,Christine Cole Johnson,Lois Lamerato,Claudine Isaacs,Douglas J. Reding,Robert T. Greenlee,Lance A. Yokochi,Bruce Kessel,E. David Crawford,Timothy R. Church,Gerald L. Andriole,Joel L. Weissfeld,Mona N. Fouad,David Chia,Barbara O'Brien,Lawrence R. Ragard,Jonathan D. Clapp,Joshua M. Rathmell,Thomas L. Riley,Patricia Hartge,Paul F. Pinsky,Claire S. Zhu,Grant Izmirlian,Barnett S. Kramer,Anthony B. Miller,Jian Lun Xu,Philip C. Prorok,John K. Gohagan,Christine D. Berg +30 more
TLDR
Among women in the general US population, simultaneous screening with CA-125 and transvaginal ultrasound compared with usual care did not reduce ovarian cancer mortality.Abstract:
Context Screening for ovarian cancer with cancer antigen 125 (CA-125) and transvaginal ultrasound has an unknown effect on mortality. Objective To evaluate the effect of screening for ovarian cancer on mortality in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Design, Setting, and Participants Randomized controlled trial of 78 216 women aged 55 to 74 years assigned to undergo either annual screening (n = 39 105) or usual care (n = 39 111) at 10 screening centers across the United States between November 1993 and July 2001. Intervention The intervention group was offered annual screening with CA-125 for 6 years and transvaginal ultrasound for 4 years. Participants and their health care practitioners received the screening test results and managed evaluation of abnormal results. The usual care group was not offered annual screening with CA-125 for 6 years or transvaginal ultrasound but received their usual medical care. Participants were followed up for a maximum of 13 years (median [range], 12.4 years [10.9-13.0 years]) for cancer diagnoses and death until February 28, 2010. Main Outcome Measures Mortality from ovarian cancer, including primary peritoneal and fallopian tube cancers. Secondary outcomes included ovarian cancer incidence and complications associated with screening examinations and diagnostic procedures. Results Ovarian cancer was diagnosed in 212 women (5.7 per 10 000 person-years) in the intervention group and 176 (4.7 per 10 000 person-years) in the usual care group (rate ratio [RR], 1.21; 95% confidence interval [CI], 0.99-1.48). There were 118 deaths caused by ovarian cancer (3.1 per 10 000 person-years) in the intervention group and 100 deaths (2.6 per 10 000 person-years) in the usual care group (mortality RR, 1.18; 95% CI, 0.82-1.71). Of 3285 women with false-positive results, 1080 underwent surgical follow-up; of whom, 163 women experienced at least 1 serious complication (15%). There were 2924 deaths due to other causes (excluding ovarian, colorectal, and lung cancer) (76.6 per 10 000 person-years) in the intervention group and 2914 deaths (76.2 per 10 000 person-years) in the usual care group (RR, 1.01; 95% CI, 0.96-1.06). Conclusions Among women in the general US population, simultaneous screening with CA-125 and transvaginal ultrasound compared with usual care did not reduce ovarian cancer mortality. Diagnostic evaluation following a false-positive screening test result was associated with complications. Trial Registration clinicaltrials.gov Identifier: NCT00002540read more
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NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines
TL;DR: Lymphedema is a common complication after treatment for breast cancer and factors associated with increased risk of lymphedEMA include extent of axillary surgery, axillary radiation, infection, and patient obesity.
Journal ArticleDOI
Rethinking ovarian cancer: recommendations for improving outcomes
Sebastian Vaughan,Jermaine Coward,Robert C. Bast,Andrew Berchuck,Jonathan S. Berek,James D. Brenton,George Coukos,Christopher C. Crum,Ronny Drapkin,Dariush Etemadmoghadam,Michael Friedlander,Hani Gabra,Stan B. Kaye,Christopher J. Lord,Ernst Lengyel,Douglas A. Levine,Iain A. McNeish,Usha Menon,Gordon B. Mills,Kenneth P. Nephew,Amit M. Oza,Anil K. Sood,Euan A. Stronach,Henning Walczak,David D.L. Bowtell,Frances R. Balkwill +25 more
TL;DR: Nine major recommendations that should be taken to improve the outcome for women with ovarian cancer are outlined in this Opinion article.
Journal ArticleDOI
Common Genetic Variation In Cellular Transport Genes and Epithelial Ovarian Cancer (EOC) Risk
Ganna Chornokur,Hui-Yi Lin,Jonathan Tyrer,Kate Lawrenson,Joe Dennis,Ernest K. Amankwah,Xiaotao Qu,Ya-Yu Tsai,Heather S.L. Jim,Zhihua Chen,Ann Y. Chen,Jennifer Permuth-Wey,Katja K.H. Aben,Hoda Anton-Culver,Natalia Antonenkova,Fiona Bruinsma,Elisa V. Bandera,Yukie Bean,Matthias W. Beckmann,Maria Bisogna,Line Bjørge,Natalia Bogdanova,Louise A. Brinton,Angela Brooks-Wilson,Clareann H. Bunker,Ralf Bützow,Ian G. Campbell,Karen Carty,Jenny Chang-Claude,Linda S. Cook,Daniel W. Cramer,Julie M. Cunningham,Cezary Cybulski,Agnieszka Dansonka-Mieszkowska,Andreas du Bois,Evelyn Despierre,Ed Dicks,Jennifer A. Doherty,Thilo Dörk,Matthias Dürst,Douglas F. Easton,Diana Eccles,Robert P. Edwards,Arif B. Ekici,Peter A. Fasching,Brooke L. Fridley,Yu-Tang Gao,Aleksandra Gentry-Maharaj,Graham G. Giles,Rosalind Glasspool,Marc T. Goodman,Jacek Gronwald,Patricia Harrington,Philipp Harter,Alexander Hein,Florian Heitz,Michelle A.T. Hildebrandt,Peter Hillemanns,Claus Høgdall,Estrid Høgdall,Satoyo Hosono,Anna Jakubowska,Allan Jensen,Bu-Tian Ji,Beth Y. Karlan,Linda E. Kelemen,Mellissa Kellar,Lambertus A. Kiemeney,Camilla Krakstad,Susanne K. Kjaer,Jolanta Kupryjanczyk,Diether Lambrechts,Sandrina Lambrechts,Nhu D. Le,Alice W. Lee,Shashi Lele,Arto Leminen,Jenny Lester,Douglas A. Levine,Dong Liang,Boon Kiong Lim,Jolanta Lissowska,Karen Lu,Jan Lubinski,Lene Lundvall,Leon F.A.G. Massuger,Keitaro Matsuo,Valerie McGuire,John R. McLaughlin,Iain A. McNeish,Usha Menon,Roger L. Milne,Francesmary Modugno,Kirsten B. Moysich,Roberta B. Ness,Heli Nevanlinna,Ursula Eilber,Kunle Odunsi,Sara H. Olson,Irene Orlow,Sandra Orsulic,Rachel Palmieri Weber,James Paul,Celeste Leigh Pearce,Tanja Pejovic,Liisa M. Pelttari,Malcolm C. Pike,Elizabeth M. Poole,Harvey A. Risch,Barry P. Rosen,Mary Anne Rossing,Joseph H. Rothstein,Anja Rudolph,Ingo B. Runnebaum,Iwona K. Rzepecka,Helga B. Salvesen,Eva S. Schernhammer,Ira Schwaab,Xiao-Ou Shu,Yurii B. Shvetsov,Nadeem Siddiqui,Weiva Sieh,Honglin Song,Melissa C. Southey,Beata Spiewankiewicz,Lara Sucheston,Soo-Hwang Teo,Kathryn L. Terry,Pamela J. Thompson,Lotte Ansgaard Thomsen,Ingvild L. Tangen,Shelley S. Tworoger,Anne M. van Altena,Robert A. Vierkant,Ignace Vergote,Christine Walsh,Shan Wang-Gohrke,Nicolas Wentzensen,Alice S. Whittemore,Kristine G. Wicklund,Lynne R. Wilkens,Anna H. Wu,Xifeng Wu,Yin Ling Woo,Hannah P. Yang,Wei Zheng,Argyrios Ziogas,Hanis Nazihah Hasmad,Andrew Berchuck,Edwin S. Iversen,Joellen M. Schildkraut,Susan J. Ramus,Ellen L. Goode,Alvaro N.A. Monteiro,Simon A. Gayther,Steven A. Narod,Paul D.P. Pharoah,Thomas A. Sellers,Catherine M. Phelan +158 more
TL;DR: Associations between inherited cellular transport gene variants and risk of EOC histologic subtypes are revealed on a large cohort of women.
Journal ArticleDOI
Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Jennifer S Lin,Margaret Piper,Leslie A Perdue,Carolyn M. Rutter,Carolyn M. Rutter,Elizabeth M. Webber,Elizabeth O'Connor,Ning Smith,Evelyn P Whitlock +8 more
TL;DR: In randomized trials conducted among average-risk, asymptomatic women, ovarian cancer mortality did not significantly differ between screened women and those with no screening or in usual care; evidence on psychological harms was limited but nonsignificant.
Journal ArticleDOI
Rethinking ovarian cancer II: Reducing mortality from high-grade serous ovarian cancer
David D.L. Bowtell,David D.L. Bowtell,Steffen Böhm,Ahmed Ashour Ahmed,Paul Joseph Aspuria,Robert C. Bast,Valerie Beral,Jonathan S. Berek,Michael J. Birrer,Sarah P. Blagden,Michael A. Bookman,James D. Brenton,Katherine B. Chiappinelli,Filipe C. Martins,George Coukos,Ronny Drapkin,Richard J. Edmondson,Christina Fotopoulou,Hani Gabra,Jérôme Galon,Charlie Gourley,Valerie Heong,David G. Huntsman,Marcin P. Iwanicki,Beth Y. Karlan,Allyson Kaye,Ernst Lengyel,Douglas A. Levine,Karen H. Lu,Iain A. McNeish,Usha Menon,Steven A. Narod,Brad H. Nelson,Kenneth P. Nephew,Paul D.P. Pharoah,Daniel J. Powell,Pilar Ramos,Iris L. Romero,Clare L. Scott,Anil K. Sood,Euan A. Stronach,Frances R. Balkwill +41 more
TL;DR: This 'roadmap' for HGSOC was determined after extensive discussions at an Ovarian Cancer Action meeting in January 2015 and aims to reduce incidence and improve outcomes for women with this disease.
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