Is ovarian cancer associated with an increased frequency of germinal inclusion cysts?

It has been proposed that epithelial ovarian cancers arise in germinal inclusion cysts of the ovary, which are thought to form as stigmata of ovulation. To evaluate whether the frequency of germinal inclusion cysts is associated with ovarian cancer, the authors counted the germinal inclusion cysts in single slides of sections from ovaries of 148 women who underwent incidental oophorectomy and from the contralateral ovaries of 37 women with unilateral ovarian cancer at Columbia-Presbyterian Medical Center, New York, New York, in 1985-1991. The mean number of germinal inclusion cysts was 2.7 for cases and 3.6 for controls. Conditional logistic regression analysis showed that germinal inclusion cysts were not associated with ovarian cancer (odds ratio = 0.98, 95% confidence interval 0.92-1.04). These findings do not support the hypothesis that increased formation of inclusion cysts is a risk factor for ovarian cancer.