Smith-Bindman R, et al. - In a large unselected population of subjects having ovarian masses, including simple cysts, researchers quantified ovarian cancer risk on the basis of ultrasonographic findings. Findings revealed a strong association between ultrasonographic appearance of ovarian masses and a woman’s risk of ovarian cancer among 72,093 women in this nested case-control study of patients enrolled in Kaiser Permanente Washington. No relation of simple cysts to an increased risk of ovarian cancer was observed, whereas complex cysts or solid masses were found to be related to a remarkably increased risk of ovarian cancer.

Methods

• A total of 72,093 women who had pelvic ultrasonography between January 1, 1997, and December 31, 2008, were included in this study.
• Researchers completed the analysis in April 2017.
• They determined ultrasonographic characteristics of ovarian masses in 1,043 women, and estimated frequencies for the entire cohort using weights derived from the sampling strategy.
• Cancer registry linkage-identified malignant ovarian cancer through December 31, 2011, was mainly assessed.

Results

• A total of 210 women with a diagnosis of ovarian cancer were included.
• Of those, 49 were younger than 50 years, and 161 were 50 years or older.
• Cancer (C statistic, 0.89) prediction was enabled by ultrasonography findings.
• Findings revealed women with complex cysts or solid masses had a remarkably elevated cancer; compared with women with normal ovaries, these subjects had likelihood ratios ranging from 8 to 74 and the 3-year risk of cancer ranging from 9 to 430 cases per 1000 women based on patient age and ultrasonography findings.
• In contrast, no remarkably increased risk of ovarian cancer was observed in 23.8% of women younger than 50 years and the 13.4% of women 50 years or older with simple cysts, compared with women with normal ovaries.
• In women younger than 50 years (no cancers were identified) and in women 50 years or older, the observed likelihood ratios related to the detection of a simple cyst were 0.00 and 0.10 (95% CI, 0.01-0.48), respectively, and the absolute 3-year risk of cancer ranged from 0 to 0.5 cases per 1000 women.