Factors associated with deciding between risk-reducing salpingo-oophorectomy and ovarian cancer screening among high-risk women enrolled in GOG-0199: an NRG Oncology/Gynecologic Oncology Group study.
Adult, Age Factors, Aged, Choice Behavior, Cohort Studies, Early Detection of Cancer, Educational Status, Female, Genes, BRCA1, Genes, BRCA2, Genetic Predisposition to Disease, Humans, Middle Aged, Multivariate Analysis, Mutation, Ovarian Neoplasms, Ovariectomy, Perception, Prophylactic Surgical Procedures, Prospective Studies, Quality of Life, Risk, Risk Reduction Behavior, Salpingectomy
OBJECTIVES: Women at increased genetic risk of ovarian cancer (OC) are recommended to have risk-reducing salpingo-oophorectomy (RRSO) after completion of reproductive planning. Effective screening has not been established, and novel screening modalities are being evaluated.
METHODS: Participants chose either RRSO or a novel OC screening regimen (OCS) as their risk management option, and provided demographic and other data on BRCA mutation status, cancer worry, perceived intervention risks/benefits, perceived cancer risk, and quality-of-life at enrollment. We performed univariate and multivariate analyses to evaluate factors influencing decision between RRSO and OCS.
RESULTS: Of 2287 participants enrolled, 904 (40%) chose RRSO and 1383 (60%) chose OCS. Compared with participants choosing OCS, participants choosing RRSO were older (p50%, both higher than objective risk estimates.
CONCLUSIONS: Cancer worry, BRCA1/2 mutation status, and perceived intervention-related risks and benefits were associated with choosing between RRSO and OCS. Efforts to promote individualized, evidence-based, shared medical decision-making among high-risk women facing management choices should focus on conveying accurate OC risk estimates, clarifying the current understanding of intervention-related benefits and limitations, and addressing OC worry.
Mai, Phuong L; Piedmonte, Marion; Han, Paul K; Moser, Richard P; Walker, Joan L; Rodriguez, Gustavo; Boggess, John; Rutherford, Thomas J; Zivanovic, Oliver; Cohn, David E; Thigpen, J Tate; Wenham, Robert M; Friedlander, Michael L; Hamilton, Chad A; Bakkum-Gamez, Jamie; Olawaiye, Alexander B; Hensley, Martee L; Greene, Mark H; Huang, Helen Q; and Wenzel, Lari, "Factors associated with deciding between risk-reducing salpingo-oophorectomy and ovarian cancer screening among high-risk women enrolled in GOG-0199: an NRG Oncology/Gynecologic Oncology Group study." (2017). Maine Medical Center. 615.