Identification of selected risk factors associated with ovarian tumor development

Abstract

Background: Ovarian cancer (OC) ranks first in mortality among gynecological malignancies, and according to the 2024 WHO report, 90–95% of ovarian tumors are diagnosed as high-grade malignant forms. Early identification of ovarian cancer risk factors is of great importance in improving diagnostic and treatment management. Aim: To investigate risk factors influencing malignant and benign ovarian tumors in women. Materials and Methods: The study was conducted using a prospective observational design between 2025 and 2026, based at the Departments of Gynecological Surgery of the National Cancer Center (NCC) and the Mongolian Japanese Teaching Hospital (MJTH). A total of 93 women aged 26–78 years diagnosed with ovarian masses (72% benign, 28% malignant) were enrolled, and data were collected using a 116-item questionnaire. Statistical analysis was performed using binary logistic regression in SPSS 25.0. Results: The mean age of the malignant group (53.45±12.97) was statistically significantly higher than that of the benign group (38.95±12.81) (p<0.0001). Lower educational level (p=0.046) and higher smoking rates (p=0.034) were observed in the malignant group. Regarding symptoms, abdominal distension (p=0.005), urinary difÏculty (p=0.016), and weight loss (p=0.002) were predominantly present in the malignant group. Multivariate logistic regression analysis showed that weight loss increased the risk of malignant ovarian tumor by 7.0-fold (OR=7.0; 95% CI: 1.74–28.14; p=0.006), urinary difÏculty by 4.05-fold (OR=4.05; 95% CI: 1.23–13.37; p=0.022), and abdominal distension by 3.52-fold (OR=3.52; 95% CI: 1.43–8.67; p=0.006). Additionally, menstrual irregularity, postmenopausal status, and family history of ovarian cancer were statistically significantly associated with malignancy. Conclusion: Malignant ovarian tumors predominantly occur in postmenopausal women, with risk increasing with age. Weight loss, urinary difÏculty, and abdominal distension are the key clinical symptoms for differentiating malignant tumors, and menstrual irregularity, menopausal status, and family history showed statistically significant associations with malignancy. The use of the HE4 biomarker and the ROMA algorithm is recommended for early detection of ovarian cancer in future practice.