Cancer Causes & Control

, 19:1357 | Cite as

Risk of epithelial ovarian cancer in relation to benign ovarian conditions and ovarian surgery

  • Mary Anne Rossing
  • Kara L. Cushing-Haugen
  • Kristine G. Wicklund
  • Jennifer A. Doherty
  • Noel S. Weiss
Original Paper

Abstract

Objective

Some forms of ovarian neoplasms may be preventable through the removal of precursor lesions. We assessed the risk associated with a prior diagnosis of, and ovarian surgery following, ovarian cysts and endometriosis, with a focus on characterizing risk among tumor subgroups.

Methods

Information was collected during in-person interviews with 812 women with ovarian cancer diagnosed in western Washington State from 2002 to 2005 and 1,313 population-based controls. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

The risk of a borderline mucinous ovarian tumor associated with a history of an ovarian cyst was increased (OR=1.7, 95% CI: 1.0–2.8), but did not vary notably according to receipt of subsequent ovarian surgery. While risk of invasive epithelial ovarian cancer was slightly increased among women with a cyst who had no subsequent ovarian surgery, it was reduced when a cyst diagnosis was followed by surgery (OR = 0.6, 95% CI: 0.4–0.9). This reduction in risk was most evident for serous invasive tumors. Women with a history of endometriosis had a threefold increased risk of endometrioid and clear cell invasive tumors, with a lesser risk increase among women who underwent subsequent ovarian surgery.

Conclusions

Our results suggest differences in the relation of ovarian cysts and endometriosis with risk of specific subtypes of ovarian cancer as well as the possibility that ovarian surgery in women with these conditions may lower the risk of invasive disease.

Keywords

Ovarian cancer Ovarian cysts Endometriosis Epidemiology 

References

  1. 1.
    Jordan SJ, Green AC, Whiteman DC, Webb PM (2007) Risk factors for benign, borderline and invasive mucinous ovarian tumors: Epidemiological evidence of a neoplastic continuum? Gynecol Oncol 107:223–230. doi:10.1016/j.ygyno.2007.06.006 Google Scholar
  2. 2.
    Jordan S, Green A, Webb P (2006) Benign epithelial ovarian tumours-cancer precursors or markers for ovarian cancer risk? Cancer Causes Control 17:623–632. doi:10.1007/s10552-005-0370-y PubMedCrossRefGoogle Scholar
  3. 3.
    Bell DA (2005) Origins and molecular pathology of ovarian cancer. Mod Pathol 18(Suppl 2):S19-S32. doi:10.1038/modpathol.3800306
  4. 4.
    Ness RB (2003) Endometriosis and ovarian cancer: thoughts on shared pathophysiology. Am J Obstet Gynecol 189:280–294. doi:10.1067/mob.2003.408 PubMedCrossRefGoogle Scholar
  5. 5.
    Shih IM, Kurman RJ (2004) Ovarian tumorigenesis: a proposed model based on morphological and molecular genetic analysis. Am J Pathol 164:1511–1518PubMedGoogle Scholar
  6. 6.
    Crum CP, Drapkin R, Kindelberger D, Medeiros F, Miron A, Lee Y (2007) Lessons from BRCA: the tubal fimbria emerges as an origin for pelvic serous cancer. Clin Med Res 5:35–44. doi:10.3121/cmr.2007.702 PubMedCrossRefGoogle Scholar
  7. 7.
    Crum CP, Drapkin R, Miron A et al (2007) The distal fallopian tube: a new model for pelvic serous carcinogenesis. Curr Opin Obstet Gynecol 19:3–9. doi:10.1097/GCO.0b013e328011a21f PubMedCrossRefGoogle Scholar
  8. 8.
    Brewer MA, Ranger-Moore J, Baruche A et al (2005) Exploratory study of ovarian intraepithelial neoplasia. Cancer Epidemiol Biomarkers Prev 14:299–305. doi:10.1158/1055-9965.EPI-04-0212 PubMedCrossRefGoogle Scholar
  9. 9.
    Lee Y, Miron A, Drapkin R et al (2007) A candidate precursor to serous carcinoma that originates in the distal fallopian tube. J Pathol 211:26–35. doi:10.1002/path.2091 PubMedCrossRefGoogle Scholar
  10. 10.
    Gilks CB (2004) Subclassification of ovarian surface epithelial tumors based on correlation of histologic and molecular pathologic data. Int J Gynecol Pathol 23:200–205. doi:10.1097/01.pgp. 0000130446.84670.93 PubMedCrossRefGoogle Scholar
  11. 11.
    Scully RE (2000) Influence of origin of ovarian cancer on efficacy of screening. Lancet 355:1028–1029. doi:10.1016/S0140-6736(00)02026-2 PubMedCrossRefGoogle Scholar
  12. 12.
    Rossing MA, Cushing-Haugen KL, Wicklund KG, Doherty JA, Weiss NS (2007) Menopausal hormone therapy and risk of epithelial ovarian cancer. Cancer Epidemiol Biomarkers Prev 16:2548–2556. doi:10.1158/1055-9965.EPI-07-0550 PubMedCrossRefGoogle Scholar
  13. 13.
    Fritz AG, Percy C, Andrew J et al (2000) International classification of diseases for oncology ICD-O. World Health Organization, GenevaGoogle Scholar
  14. 14.
    Tavassoli FA, Devilee P (2003) World Health Organization classification of tumours. Pathology and genetics of tumours of the breast and female genital organs. IARC Press, LyonGoogle Scholar
  15. 15.
    Waksberg J (2000) Random digit dialing sampling for case-control studies. In: Gail MH, Benichou J (eds) Encyclopedia of epidemiologic methods. Wiley, New York, pp 749–753Google Scholar
  16. 16.
    Rossing MA, Cushing-Haugen KL, Wicklund KG, Weiss NS (2008) Cigarette smoking and risk of epithelial ovarian cancer. Cancer Causes Control 19:413–420PubMedCrossRefGoogle Scholar
  17. 17.
    Weiss NS, Rossing MA (1996) Healthy screenee bias in epidemiologic studies of cancer incidence. Epidemiology 7:319–322PubMedGoogle Scholar
  18. 18.
    Kreiger N, Sloan M, Cotterchio M, Parsons P (1997) Surgical procedures associated with risk of ovarian cancer. Int J Epidemiol 26:710–715. doi:10.1093/ije/26.4.710 PubMedCrossRefGoogle Scholar
  19. 19.
    Chiaffarino F, Parazzini F, Decarli A et al (2005) Hysterectomy with or without unilateral oophorectomy and risk of ovarian cancer. Gynecol Oncol 97:318–322. doi:10.1016/j.ygyno.2005.01.030 PubMedCrossRefGoogle Scholar
  20. 20.
    Beard CM, Hartmann LC, Atkinson EJ et al (2000) The epidemiology of ovarian cancer: a population-based study in Olmsted County, Minnesota, 1935–1991. Ann Epidemiol 10:14–23. doi:10.1016/S1047-2797(99)00045-9 PubMedCrossRefGoogle Scholar
  21. 21.
    Ness RB, Cramer DW, Goodman MT et al (2002) Infertility, fertility drugs, and ovarian cancer: a pooled analysis of case-control studies. Am J Epidemiol 155:217–224. doi:10.1093/aje/155.3.217 PubMedCrossRefGoogle Scholar
  22. 22.
    Parazzini F, Moroni S, La Vecchia C et al (1997) Ovarian cancer risk and history of selected medical conditions linked with female hormones. Eur J Cancer 33:1634–1637. doi:10.1016/S0959-8049(97)00011-7 PubMedCrossRefGoogle Scholar
  23. 23.
    Dal Maso L, Canzonieri V, Talamini R, Franceschi S, La Vecchia C (2001) Origin of ovarian cancer from benign cysts. Eur J Cancer Prev 10:197–199. doi:10.1097/00008469-200104000-00016 PubMedCrossRefGoogle Scholar
  24. 24.
    Borgfeldt C, Andolf E (2004) Cancer risk after hospital discharge diagnosis of benign ovarian cysts and endometriosis. Acta Obstet Gynecol Scand 83:395–400. doi:10.1111/j.0001-6349.2004.00305.x PubMedCrossRefGoogle Scholar
  25. 25.
    Crayford TJ, Campbell S, Bourne TH, Rawson HJ, Collins WP (2000) Benign ovarian cysts and ovarian cancer: a cohort study with implications for screening. Lancet 355:1060–1063. doi:10.1016/S0140-6736(00)02038-9 PubMedCrossRefGoogle Scholar
  26. 26.
    Brinton LA, Sakoda LC, Sherman ME et al (2005) Relationship of benign gynecologic diseases to subsequent risk of ovarian and uterine tumors. Cancer Epidemiol Biomarkers Prev 14:2929–2935. doi:10.1158/1055-9965.EPI-05-0394 PubMedCrossRefGoogle Scholar
  27. 27.
    Kobayashi H, Sumimoto K, Moniwa N et al (2007) Risk of developing ovarian cancer among women with ovarian endometrioma: a cohort study in Shizuoka, Japan. Int J Gynecol Cancer 17:37–43. doi:10.1111/j.1525-1438.2006.00754.x PubMedCrossRefGoogle Scholar
  28. 28.
    Erzen M, Rakar S, Klancnik B, Syrjanen K (2001) Endometriosis-associated ovarian carcinoma (EAOC): an entity distinct from other ovarian carcinomas as suggested by a nested case-control study. Gynecol Oncol 83:100–108. doi:10.1006/gyno.2001.6382 PubMedCrossRefGoogle Scholar
  29. 29.
    Melin A, Sparen P, Persson I, Bergqvist A (2006) Endometriosis and the risk of cancer with special emphasis on ovarian cancer. Hum Reprod 21:1237–1242. doi:10.1093/humrep/dei462 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Mary Anne Rossing
    • 1
    • 2
  • Kara L. Cushing-Haugen
    • 1
  • Kristine G. Wicklund
    • 1
  • Jennifer A. Doherty
    • 1
  • Noel S. Weiss
    • 1
    • 2
  1. 1.Program in EpidemiologyFred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Department of Epidemiology, School of Public Health and Community MedicineUniversity of WashingtonSeattleUSA

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