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One major concern was that the confidence of the findings was affected by inclusion criteria for uterine myoma and unmeasured confounders. However, a definitive diagnosis with International Classification of Diseases, 9th revision, clinical modification (ICD-9-CM) codes in the administrative data has important implications for the treatment of women with prior uterine myoma; thus, our patient selection criteria must be as precise as possible to weed out potential errors and increase diagnostic accuracy. In addition, to minimize selection bias, frequency matching can ensure that cases and controls have the same frequencies of exposure to potentially confounding factors for comparison [3]. Although other unmeasured factors may influence the results, these findings have important implications for understanding the impact of prior uterine myoma on the development of subsequent ovarian cancer.

Response to comment on: prior uterine myoma and risk of ovarian cancer: a population-based case-control study