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PLCO
About the Trial
The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial randomized about 155,000 adults to periodic screening or usual care across four cancer sites. Annual PSA plus digital rectal exam did not reduce prostate cancer mortality versus usual care, though contamination limited power. Ovarian screening with CA 125 and ultrasound showed no mortality benefit and significant harm from surgeries for benign findings. Chest X ray screening showed no lung cancer benefit, later superseded by NLST low dose CT. The colorectal arm contributed flexible sigmoidoscopy evidence, cutting mortality by 26 percent. PLCO remains the great cautionary encyclopedia of screening both benefits and harms.
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