Complex ovarian cysts in postmenopausal women are not associated with ovarian cancer risk factors

Preliminary data from the prostate, lung, colon, and ovarian cancer screening trial

Patricia Hartge, Richard Hayes, Douglas Reding, Mark E. Sherman, Philip Prorok, Mark Schiffman, Saundra Buys

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVE: We assessed whether asymptomatic ovarian abnormalities detected on ultrasonography in postmenopausal women are precursors to ovarian cancer. STUDY DESIGN: We compared the transvaginal ultrasonographic findings from the initial examination of 20,000 postmenopausal women enrolled to date in an ongoing randomized trial of cancer screening with data on the established risk factors for ovarian cancer obtained from self-administered questionnaires. We distinguished cysts with the suggestive characteristic(s) of a septum, a solid component, or an irregular or thick wall ('complex cysts') from simple sonolucent cysts with none of those features. RESULTS: High parity, a strong ovarian cancer protective factor, was negatively associated with complex cysts (odds ratio for ≥5 births vs no births, 0.72; 95% confidence interval, 0.53-0.97), but long-term oral contraceptive use, another strong ovarian cancer protective factor, was not associated with complex cysts (odds ratio, 0.96; 95% confidence interval, 0.76-1.20). A family history of ovarian cancer or multiple breast cancers, a strong risk factor for cancer, was not associated with complex cysts (odds ratio, 0.99; 95% confidence interval, 0.68-1.44). Other abnormalities found on ultrasonography (including simple cysts, bilateral cysts, or all abnormalities combined) also did not share the established risk factors for ovarian malignancy. We did not identify any combination of features of abnormalities (septum, echogenicity, size, or papillary projections) that manifested the cancer risk factor profile. CONCLUSIONS: Although a very small proportion of the clinically silent ovarian abnormalities found on ultrasonography are determined to be ovarian cancers, the remaining complex cysts and other clinically suspicious abnormalities do not appear to be the immediate precursors of ovarian cancer. The eventual identification of such precursors will yield opportunities for earlier diagnosis, screening of high-risk groups, and better understanding of the cause of this often lethal malignancy.

Original languageEnglish (US)
Pages (from-to)1232-1237
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume183
Issue number5
DOIs
StatePublished - 2000

Fingerprint

Ovarian Cysts
Early Detection of Cancer
Ovarian Neoplasms
Colonic Neoplasms
Cysts
Lung Neoplasms
Prostatic Neoplasms
Ultrasonography
Odds Ratio
Confidence Intervals
Neoplasms
Parturition
Oral Contraceptives
Parity
Early Diagnosis
Breast Neoplasms

Keywords

  • Epidemiology
  • Ovarian cancer
  • Ovarian cysts
  • Precursors
  • Screening
  • Ultrasonography

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Complex ovarian cysts in postmenopausal women are not associated with ovarian cancer risk factors : Preliminary data from the prostate, lung, colon, and ovarian cancer screening trial. / Hartge, Patricia; Hayes, Richard; Reding, Douglas; Sherman, Mark E.; Prorok, Philip; Schiffman, Mark; Buys, Saundra.

In: American Journal of Obstetrics and Gynecology, Vol. 183, No. 5, 2000, p. 1232-1237.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: We assessed whether asymptomatic ovarian abnormalities detected on ultrasonography in postmenopausal women are precursors to ovarian cancer. STUDY DESIGN: We compared the transvaginal ultrasonographic findings from the initial examination of 20,000 postmenopausal women enrolled to date in an ongoing randomized trial of cancer screening with data on the established risk factors for ovarian cancer obtained from self-administered questionnaires. We distinguished cysts with the suggestive characteristic(s) of a septum, a solid component, or an irregular or thick wall ('complex cysts') from simple sonolucent cysts with none of those features. RESULTS: High parity, a strong ovarian cancer protective factor, was negatively associated with complex cysts (odds ratio for ≥5 births vs no births, 0.72; 95{\%} confidence interval, 0.53-0.97), but long-term oral contraceptive use, another strong ovarian cancer protective factor, was not associated with complex cysts (odds ratio, 0.96; 95{\%} confidence interval, 0.76-1.20). A family history of ovarian cancer or multiple breast cancers, a strong risk factor for cancer, was not associated with complex cysts (odds ratio, 0.99; 95{\%} confidence interval, 0.68-1.44). Other abnormalities found on ultrasonography (including simple cysts, bilateral cysts, or all abnormalities combined) also did not share the established risk factors for ovarian malignancy. We did not identify any combination of features of abnormalities (septum, echogenicity, size, or papillary projections) that manifested the cancer risk factor profile. CONCLUSIONS: Although a very small proportion of the clinically silent ovarian abnormalities found on ultrasonography are determined to be ovarian cancers, the remaining complex cysts and other clinically suspicious abnormalities do not appear to be the immediate precursors of ovarian cancer. The eventual identification of such precursors will yield opportunities for earlier diagnosis, screening of high-risk groups, and better understanding of the cause of this often lethal malignancy.",
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AU - Prorok, Philip

AU - Schiffman, Mark

AU - Buys, Saundra

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