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Reexamine trial outcomes in PLCO to identify interactions of screening effects with screen results and other covariates (Original Project: PLCO-1091)

Principal Investigator

Name
Hormuzd Katki

Degrees
Ph.D.

Institution
American Cancer Society

Position Title
Scientific Vice President, Center for Early Cancer Detection

Email
hormuzd.katki@cancer.org

About this CDAS Project

Study
PLCO (Learn more about this study)

Project ID
PLCO-2043

Initial CDAS Request Approval
Apr 28, 2026

Title
Reexamine trial outcomes in PLCO to identify interactions of screening effects with screen results and other covariates (Original Project: PLCO-1091)

Summary
We will reexamine trial outcomes (mortality and late-stage cancer incidence) for each of the P L C and O cancers over time by screen results and covariates. We will recalculate survival curves for each P L C and O trial outcomes to compare cancer mortality versus late-stage stage cancer incidence. We will estimate survival curves by screening results and covariates to examine interactions of arm by screening result and covariates. We will examine the contribution of "intrastage-shift" effects to the cancer mortality reductions. We will project results from the Intended Effect analysis if it had been used in PLCO and compare to the standard analysis

Aims

* Recalculate survival curves for each P L C and O trial outcomes to compare cancer mortality versus late-stage stage cancer incidence
* Estimate survival curves by screening results and covariates to examine interactions of arm by screening result and covariates
* Examine the contribution of "intrastage-shift" effects to the cancer mortality reductions
* We will project results from the Intended Effect analysis if it had been used in PLCO (Katki HA, Prorok PC, Castle PE, Minasian LM, Pinsky PF. Increasing power in screening trials by testing control-arm specimens: application to multicancer detection screening. JNCI: Journal of the National Cancer Institute. 2024 Oct;116(10):1675-82.)
* Time-varying effects of screening efficacy, cancer incidence (overdiagnosis), and survival differences between arms (incidence-based mortality).
* Adjust for risk imbalances between arms and for competing mortality.

Collaborators

Li Cheung NCI
Hormuzd Katki American Cancer Society
Rebecca Landy American Cancer Society
Paul Pinsky NCI