Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial

The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, or PLCO, is a National Institutes of Health (NIH)/National Cancer Institute (NCI)-funded large-scale clinical trial to determine whether certain cancer screening tests reduce deaths from prostate, lung, colorectal and ovarian cancer. In addition, there are numerous epidemiologic and ancillary studies going on that will answer other crucial questions about these cancers and these screening tests.

Dr. Gerald L. Andriole is the principal investigator for Washington University PLCO in addition to being professor and chief of the Division of Urologic Surgery. He is also chairman of the Prostate Committee for PLCO and on the NCI’s Advisory Board for the PLCO Biorepository.

More than 154,000 women and men joined the PLCO trial between 1992 and 2001 at 10 centers across the country. These participants were between the ages of 55 and 74 when they joined. Half of these participants were selected by chance to receive specific screening tests and half receive routine care by their personal health care providers. All participants provide regular updates on a variety of health measurements in an annual questionnaire, as well as blood samples for use in studies of biologic markers of cancer risk from the screened group.

Prostate, lung, colorectal and ovarian cancers account for more than 48 percent of all cancers diagnosed and 49 percent of all cancer deaths in the United States. About 255,600 people will die from these cancers this year.

PLCO is sponsored and run by the National Cancer Institute, one of the National Institutes of Health and part of the U.S. Public Health Service. As one of the 10 centers nationwide, Washington University has more than 15,000 participants enrolled. The Washington University PLCO office is conveniently located at the Barnes West County Campus area.

Upon entry, participants were divided by chance into one of the two study groups. The control group receives routine health care with their primary care physician. The screened group receives a series of exams to detect prostate, lung, colorectal or ovarian cancer.

Both women and men are screened for colorectal cancer through sigmoidoscopy and lung cancer with a chest x-ray.

Women are screened for ovarian cancer with both the CA-125 test and a transvaginal ultrasound (TVU).

All men receive the prostate serum antigen (PSA) test and digital rectal examination (DRE) to detect the presence of prostate cancer.

Participants in the screened group undergo exams for a total of six years, and receive follow-up for another 10 years. The schedule of screening exams is as follows:

Test	Frequency
PSA	Initial visit, annually for 5 years
DRE	Upon entry, annually for 3 years
Chest x-ray	Smokers upon entry, annually for 3 years
	Never smokers upon entry, annually for 2 years
Sigmoidoscopy	Upon entry, one after 5 years in study
TVU	Upon entry, annually for 3 years
CA125	Initial visit, annually for 5 years

Additionally, all participants complete a study questionnaire once a year for up to 16 years of the duration of the study.

Since the beginning of the study, several sub-studies or ancillary studies have branched from the PLCO contract.

The Virtual Colonoscopy Study was one such study that looked at different colon cancer screening modes. Dr. Elizabeth McFarland conducted this study at Washington University.

The National Lung Screening Trial is another sub study. This is a large-scale study that involves all 10 PLCO screening centers along with several ACRN centers. This study compares two ways of detecting lung cancer: standard chest X-ray and spiral computed tomography (CT) scan. This study has completed enrollment with over 3,700 participants enrolled at Washington University and over 50,000 participants enrolled with all the centers combined. Washington University’s lead investigator is Dr. David Gierada.

Another ancillary study is the Aberrant Crypt Foci (ACF) Study. This study involves four of the ten PLCO screening centers. The purpose of the ACF study is to determine whether the detection of abnormal cells in the colon can serve as an early predictor of colon cancer. Washington University’s lead investigator in this study is Dr. Matthew Mutch.

There are plans for PLCO expanding opportunities in hopes of launching several other sub or ancillary type studies.

Dr. Gerald L. Andriole's CV