Association Between Risk of Ovarian Cancer and Ultrasonography Findings
Posted: Thursday, January 3, 2019
Complex ovarian cysts and solid masses are significantly associated with an increased risk of ovarian cancer, whereas simple ovarian cysts and those with low-level echoes are not. These findings, which are from a groundbreaking nested case-control study among 72,093 women, were published in JAMA Internal Medicine. Thus, the authors indicate that simple cysts “should be considered normal findings and do not need surveillance.”
Rebecca Smith-Bindman, MD, of the University of California, San Francisco, and colleagues noted that increased, and higher-quality, ultrasonography use “has led to the identification of imaging findings without clear criteria about what images require further evaluation.” The team set out to describe “the prevalence of ovarian masses (and their appearance) and cancer outcomes among a well-defined, unselected population…[to quantify] absolute risks of [ovarian] cancer based on imaging characteristics [and to compare] these risks with those among women without such findings,” they wrote.
Age as well as cyst/mass composition was important. In the study population of women aged up to 50 years, the authors described, likelihood ratios for developing cancer were 8.20, 8.34, and 8.08 for those with complex cysts, complex cysts with ascites, and solid masses, respectively; among those aged 50 years and older, the likelihood ratios were 7.60, 74.17, and 10.08, respectively. The 3-year risks of cancer per 1,000 women with these findings were 9.4, 11.0, and 8.9, respectively, for those aged up to 50 years, and—strikingly—65.2, 429.8, and 101.6, respectively, for those aged 50 years and older.
On the other hand, based on their results, Dr. Smith-Bindman and colleagues deem simple cysts to be “frequently encountered…incidental and normal.” With an associated absolute 3-year risk of cancer ranging from 0 to 0.5 cases per 1,000 women of all ages, the authors noted that additional evaluation is not warranted for those cysts.
Disclosure: The study authors reported no conflicts of interest.