Tumeurs frontières de l’ovaire. Recommandations pour la pratique clinique du CNGOF – Aspects épidémiologiques et facteurs de risque.

The incidence (rate /100,000) of BOT gradually increases with age from 15-19 years of age and peaks at nearly 4.5 cases/100,000 for the 55-59 year age group (NP3). In the presence of a benign ovarian mass, the standardized risk ratio of serous and mucinous BOT is 1.69, (95% CI 1.39-2.03) and 1.75, (95% CI 1.45-2.10), respectively (NP2). At diagnosis, a median age of diagnosis of OFA is 46 years, unilateral forms (79.7% of cases) are predominant compared to cancers (45.3%) (<0.001) and FIGO I stages represent nearly 63.7% of cases (NP3). The 5-year survival rates for FIGO I, II, III, IV stages are: 99.7% (95% CI: 96.2-100%), 99.6% (95% CI: 92.6-100%), 95.3% (95% CI: 91.8-97.4%), 77.1% (95% CI: 58.0-88.3%), respectively (NP3). Survivors at 5 years for serous and mucinous tumours are 99.7% (95% CI: 99.2-99.9%), 98.5% (95% CI: 96.9-99.3%), respectively (NP3). An epidemiological association exists between personal BOT risk and : 1) a familial history of BOT/certain cancers (pancreas, lung, bone, leukemia) (NP3), 2) a personal history of benign ovarian cyst (NP2), 3) a personal history of pelvic inflammatory disease(IGH), 4) the use of intrauterine device Levonorgestrel (NP3), 5) the use of oral contraceptive pills (NP3), 6) multiparity (NP3), 7) hormone replacement therapy (NP3), 8) High consumption of Coumestrol (NP4), 9) medical treatment of infertility with progesterone (NP3), 10) Non steroidal anti-inflammatory drug( NSAID). An epidemiological association exists between previous/ actual tabacco consumption and the risk of mucinous ovarian BOT (NP2). Relative risk (RR) varies between 2.2 and 2.7, however the relationship is not necessarily a causal one. An epidemiological association exists between overweight/obesity and the risk of serous BOT (NP2). RR varies between 1.2 to 1.8. The high Vitamin D was inversely associated to the risk of serous BOT(NP4). The risk of mucinous BOT was lowered with Paracetamol use (OR = 0.77; 95% CI: 0.60-0.98) (NP3) However, the relationship between these factors and BOT is not necessarily a causal one and no screening modality can be proposed in the general population (grade C).