Ultrasound-identified ovarian cysts: a guide to interpretation, management, and follow-up

Abstract

ne of the challenges of providers of reproductive health care is how to evaluate and manage women with adnexal masses. While only a small percentage of adnexal cysts are malignant ranging from 0.3% of unilocular cysts to 3% of more radiologically complex neoplasms, the risk of cancer increases with age, family and personal history of cancers, genetic mutations, and symptoms. 1 The International Agency for Research on Cancer reported 313,959 new ovarian cancer cases worldwide in 2020 with 170,759 cases in Asia (54.4% of all reported female cancers) and 26,630 cases (8.5%) in North America. 2,3 In the United States, while ovarian cancer is only 1.0% of all new cancer cases, it contributes to 2.1% of all cancer deaths. Table 1 shows the grim statistics. However, in the 45 years of the US Surveillance, Epidemiology, and End Results Program, data collection from 1975 through 2019 show the rates of new ovarian cancer cases and deaths have fallen from 15.89 new cases to 9.33 cases per 100,000 women and from 9.4 to 6.01 deaths per 100,000 women. 4 This success