Risks of non-ovarian cancers in women with borderline ovarian tumor: a national cohort study in Sweden

Arturas Dobilas; Filip Jansåker; Xinjun Li; Kristina Sundquist; Christer Borgfeldt

doi:10.1186/s12885-023-11453-6

Risks of non-ovarian cancers in women with borderline ovarian tumor: a national cohort study in Sweden

BMC Cancer. 2023 Oct 9;23(1):951. doi: 10.1186/s12885-023-11453-6.

Authors

Arturas Dobilas^{1

2}, Filip Jansåker^{3

4}, Xinjun Li³, Kristina Sundquist^{3

5

6

7}, Christer Borgfeldt^{8

9}

Affiliations

¹ Department of Obstetrics and Gynaecology, Skåne University Hospital, Klinikgatan 12, Lund, 221 85, Sweden. arturas.dobilas@med.lu.se.
² Department of Clinical Science Lund, Lund University, Lund, Sweden. arturas.dobilas@med.lu.se.
³ Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
⁴ Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark.
⁵ Center for Community-Based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan.
⁶ Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, USA.
⁷ Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA.
⁸ Department of Obstetrics and Gynaecology, Skåne University Hospital, Klinikgatan 12, Lund, 221 85, Sweden.
⁹ Department of Clinical Science Lund, Lund University, Lund, Sweden.

Abstract

Background: Associations between different cancer types are known. The affirmation of the risk for non-ovarian cancer after ovarian borderline tumors (BOT) is, however, sparse.

Aim: To analyze the risk of subsequent or simultaneous cancers in women with BOTs compared with the general female Swedish population.

Methods: An open cohort study (1995-2018) was conducted where a diagnosis of BOTs as well as subsequent or simultaneous cancer diagnoses were obtained from the Swedish Cancer Register and matched to the Total Population Register. Each woman with BOT was followed until non-ovarian cancer, death or emigration and could only be included once for the outcome. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) for specific non-ovarian cancers were analyzed.

Results: The 4998 women with serous and mucinous BOTs were diagnosed during 1995-2018 with a mean age of 55.7 years (SD 16.0) at diagnosis. Compared with the general female population, women with BOTs had increased risks for non-ovarian cancer in colon (SIR = 2.5; 95% CI 2.0-3.1), rectum (SIR = 1.7; 95% CI 1.1-2.5), small intestine (SIR = 5.0; 95% CI 2.3-9.5), cervix (SIR = 2.5; 95% CI 1.4-4.2), endometrium (SIR = 2.4; 95% CI 1.9-3.1), pancreas (SIR = 2.3; 95% CI 1.4-3.5), upper aerodigestive tract (SIR = 2.2; 95% CI 1.2-3.8), lung (SIR = 1.8; 95% CI 1.4-2.3), kidney (SIR = 2.3; 95% CI 1.4-3.7) and bladder (SIR = 1.8; 95% CI 1.1-2.8). Among women with serous BOTs, the risk of thyroid gland cancer (SIR = 3.1; 95% CI 1.2-6.4) was also increased. Lung and pancreas cancer showed increased risks more than 1 year after a diagnosis of BOT.

Conclusions: This Swedish population-based study demonstrated an increased risk of multiple malignancies including lung and pancreatic cancers beyond the first year of diagnosis in patients with borderline ovarian tumors (BOTs), suggesting a potential shared etiology.

Keywords: Borderline ovarian tumors; Cancer risk; Cohort study; Nationwide; Standardized incidence ratios.

MeSH terms

Cohort Studies
Female
Humans
Incidence
Middle Aged
Ovarian Neoplasms* / epidemiology
Ovarian Neoplasms* / pathology
Risk Factors
Sweden / epidemiology