Removing Benign Ovarian Cysts Does Not Affect Cancer Risk
In the earlier screening trial, the ultrasound had detected an ovarian abnormality that required surgical evaluation in 326 of the women. Nine of the 293 women who agreed to have surgery were diagnosed with ovarian cancer, and 112 had benign ovarian tumors. The others were found to have tumor-like conditions such as simple cysts. A total of 202 of the women had their ovaries and fallopian tubes removed.
"We believe that if the removal of benign (premalignant) cysts were to have an important effect on screening programmes, the subsequent incidence of ovarian cancer should have been reduced by at least 40%," write the authors.
However, the researchers found this did not occur. In the years that followed, 387 of the women who had taken part in the screening trial died. The cause of death in 221 of them was cancer; and 22 died of ovarian cancer -- slightly less than the number of deaths that would normally be expected from the malignancy, based on population and epidemiologic data.
"There have been other studies that looked at this, and no one was ever able to prove anything. But none of those studies had this number of patients. In the early '80s, when this work was done, Ca-125 [a tumor marker found in blood] didn't even exist, so ultrasound was the only thing we knew to use," Thomas Lallas, MD, tells WebMD. Lallas, a specialist in ovarian cancer at Lenox Hill Hospital in New York, was not involved in the study.
"We recommend that [women at high risk for ovarian cancer] see a gynecologic oncologist every six months to have a blood test for CA-125, a pelvic examination, and a transvaginal ultrasound. That's pretty much the state-of-the-art care," says Bodurka-Bevers, who is assistant professor of gynecologic oncology at the University of Texas M.D. Anderson Cancer Center in Houston.