Most simple ovarian cysts require no treatment, surveillance

Nov. 12 (UPI) — Simple ovarian cysts have almost zero percent chance of developing into cancer, and therefore women don’t need to have them surgically removed or monitored with ultrasound, according to a new study.

“Simple cysts are almost universally benign, but because of concern that they could harbor a cancer precursor, they have resulted in frequent surveillance and referrals to gynecologists and oncologists,” corresponding author Rebecca Smith-Bindman, an author of the study and UCSF professor in the Department of Radiology and Biomedical Imaging, said in a press release. “Our study found that asymptomatic simple cysts of any size should be considered normal findings in women of any age and ignored.”

The research, published in JAMA Internal Medicine, is the first to estimate ovarian cancer risk based on ultrasound characteristics.

“One of the justifications for the surveillance of simple cysts is that imaging may be inaccurate and might miss complex features,” Smith-Bindman said. “This was not supported by our data. Cysts interpreted as being simple, even extremely large ones, were not associated with cancer.”

The research looked at over 72,000 women and nearly 119,00 pelvic ultrasound exams over 12 years. This is the first study to quantify the risk of ovarian cancer in a large, unselected population, based on the ultrasound characteristics of ovarian masses, including simple cysts.

The study suggests the uptick in the use of transvaginal pelvic ultrasound has brought about higher detection of ovarian masses, many of which are just simple cysts. Ovarian cancer still remains the fifth leading cause of cancer deaths in the United States, leading to 22,000 new cases diagnosed and 14,000 deaths each year.

Additionally, 6.5 percent of post-menopausal women with complex cysts receive an ovarian cancer diagnosis within three years.

“I understand why women and physicians do not want to misdiagnose ovarian cancer,” she said. “Ovarian cancer is a devastating disease. But ovarian cancer does not arise in simple cysts and following simple cysts with imaging will not result in improved early detection of ovarian cancer.”