NEW YORK, Mar 24 (Reuters Health) -- Removing noncancerous ovarian cysts does not appear to reduce a woman's odds of dying from ovarian cancer, according to results of study. The findings suggest that ultrasound screening -- a hoped-for test for ovarian cancer -- may not be that useful.
Ovarian cancer is highly treatable if detected early, but the disease is difficult to diagnose until it progresses to a more deadly stage. Currently, there is no accurate and easy-to-perform screening test for ovarian cancer, such as the mammogram used to detect breast cancer.
Ultrasound testing to detect ovarian cysts has been under consideration as a screen for ovarian cancer, based on the idea that some noncancerous, or benign, ovarian cysts might eventually become malignant. The hope was that removing cysts detected by ultrasound would reduce a woman's odds of later dying from ovarian cancer.
But the results of the current study, published in the March 25th issue of the medical journal The Lancet, indicate that ultrasound testing falls short as a screen for ovarian cancer.
"Our study is a setback for those hoping to find a screening test for this serious disease," the lead author of the study, Dr. Timothy J.B. Crayford, of King's College Hospital in London, UK, told Reuters Health. In the long run, one or two ultrasound screens for ovarian cancer are not likely to protect healthy women, according to Crayford.
Crayford and his colleagues based the findings on follow-up data from a study conducted between 1981 and 1987, in which 5,135 healthy women underwent ultrasound screening for ovarian cancer.
Since the women tended to be healthier than women in the general population, the number of deaths from all causes in the 15-year period after the study was lower than expected, according to the report. The expected number of deaths due to ovarian cancer was 25, and only 22 women died from the disease. But overall, the authors conclude that having benign cysts removed was not linked with any reduction in the risk of dying from ovarian cancer.
"This research suggests that most benign cysts in middle-aged women would probably do no harm if they were left in place," Crayford told Reuters Health. "But there is still a problem in trying to distinguish them from the malignant ones."
What is needed, according to Crayford, is a nonsurgical test that can tell whether a cyst is malignant or benign without surgery. Then benign cysts could be left in place. But it is too soon to say that benign cysts should definitely not be removed, according to Crayford. "The only option for now is to take any out that cannot be ruled out as malignant," he noted.
In an editorial that accompanies the study, Dr. Robert E. Scully, of Harvard Medical School in Boston, Massachusetts, points out that though the findings do not rule out the possibility that some benign cysts may eventually become cancerous, the results of the study suggest that most cases of ovarian cancer do not develop from large, benign cysts that can be detected with ultrasound testing.