title: Assessing the malignant potential of ovarian inclusion cysts in postmenopausal women within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a prospective cohort study.
abstract: OBJECTIVE
  To evaluate the malignant potential of ultrasound-detected ovarian inclusion cysts in the development of ovarian cancer (OC) in postmenopausal women.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).
  
  
  METHODS
  Postmenopausal women.
  
  
  METHODS
  In UKCTOCS, women in the ultrasound group have annual scans. Women with inclusion cysts (single/multiple anechoic ≤10-mm ovarian cysts) and normal ovaries (both uniform hypoechogenicity) on their first scan were identified and followed up through cancer registry/questionnaires.
  
  
  METHODS
  Relative risk (RR) of developing OC, invasive epithelial ovarian cancer (iEOC), breast cancer (BC) and endometrial cancer (EC) in women with inclusion cysts relative to those with normal ovaries. The incidence was compared with UK age-adjusted expected rates (Office for National Statistics, 2005).
  
  
  RESULTS
  Postmenopausal women (n = 48,230) attended the year 1 (11 June 2001-6 December 2006) screen; 1234 (2.5%) had inclusion cysts alone and 22,914 had normal scans. By 1 November 2009 (median follow-up, 6.13 years; interquartile range, 4.96-6.98 years), four, three (one Type II), seven and 22 women with inclusion cysts and 32, 29 (20 Type II), 90 and 397 women with normal ovaries were diagnosed with OC, iEOC, EC and BC, respectively. The RR values for the respective cancers (OC [RR, 2.32; confidence interval [CI], 0.86-6.28], iEOC [RR, 1.92; CI, 0.62-5.92], EC [RR, 1.44; CI, 0.68-3.05], BC [RR, 1.12; CI, 0.73-1.73]) were not increased. There was no difference between the observed versus expected incidence rates for these cancers in women with inclusion cysts.
  
  
  CONCLUSIONS
  Postmenopausal women with ultrasound-detected inclusion cysts do not seem to be at increased risk of ovarian or breast/endometrial (hormone-dependent) cancers.
authors.affiliation: Gynaecological Cancer Research Centre, University College London, EGA Institute for Women's Health, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: A
authors.initials: A
authors.lastname: Gentry-Maharaj
authors.forename: M
authors.initials: M
authors.lastname: Burnell
authors.forename: E-O
authors.initials: EO
authors.lastname: Fourkala
authors.forename: S
authors.initials: S
authors.lastname: Campbell
authors.forename: N
authors.initials: N
authors.lastname: Amso
authors.forename: M W
authors.initials: MW
authors.lastname: Seif
authors.forename: A
authors.initials: A
authors.lastname: Ryan
authors.forename: M
authors.initials: M
authors.lastname: Parmar
authors.forename: I
authors.initials: I
authors.lastname: Jacobs
authors.forename: U
authors.initials: U
authors.lastname: Menon
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000209:etiology / Q000473:pathology*; D000077216:Carcinoma, Ovarian Epithelial; D002471:Cell Transformation, Neoplastic; D055088:Early Detection of Cancer / Q000379:methods; D016889:Endometrial Neoplasms / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D011230:Precancerous Conditions / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography