TY - JOUR
T1 - Attitudes towards Risk Reducing Early Salpingectomy with Delayed Oophorectomy for Ovarian Cancer Prevention: a Cohort Study
AU - Gaba, Faiza
AU - Blyuss, Oleg
AU - Chandrasekaran, Dhivya
AU - Osman, Miski
AU - Goyal, Shivam
AU - Gan, Carmen
AU - Izatt, Louise
AU - Tripathi, Vishakha
AU - Esteban, Irene
AU - McNicol, Lewis
AU - Ragupathy, Kalpana
AU - Crawford, Robin
AU - Evans, D Gareth
AU - Legood, Rosa
AU - Menon, Usha
AU - Manchanda, Ranjit
PY - 2020/7/13
Y1 - 2020/7/13
N2 - Objective: To determine risk-reducing-early-salpingectomy-and-delayed-oophorectomy (RRESDO) acceptability and effect of surgical prevention on menopausal sequelae/satisfaction/regret in women at increased ovarian-cancer (OC) risk.
Design: Multicentre, cohort, questionnaire-study (IRSCTN:12310993).
Setting: United-Kingdom (UK).
Population: OC unaffected UK-women ≥18years, at increased OC-risk, with/without previous RRSO, ascertained through specialist familial-cancer/genetic-clinics and BRCA support-groups.
Methods: Participants completed a 39-item questionnaire. Baseline characteristics were described using descriptive statistics. Logistic/linear-regression models analysed impact of variables on RRESDO acceptability and health-outcomes.
Main Outcomes: RRESDO acceptability, menopausal-sequelae, satisfaction/regret.
Results: 346 of 683 participants underwent risk-reducing salpingo-oophorectomy (RRSO) and 337 did not. 69.1% (181/262) premenopausal women who had not undergone RRSO found it acceptable to participate in a research study offering RRESDO. Premenopausal women concerned about sexual-dysfunction were more likely (OR=2.9, 95%CI=1.2-7.7, p=0.025) to find RRESDO acceptable. Women experiencing sexual-dysfunction after premenopausal-RRSO were more likely to find RRESDO acceptable in retrospect (OR=5.3, 95%CI=1.2-27.5, p<0.031). 88.8%(143/161) premenopausal versus 95.2%(80/84) postmenopausal women who underwent RRSO respectively were satisfied with their decision. 9.4%(15/160) premenopausal and 1.2%(1/81) postmenopausal women who underwent RRSO regretted their decision. HRT-uptake in breast-cancer (BC) unaffected premenopausal individuals was 74.1% (80/108). ). HRT-use did not significantly affect satisfaction/regret levels but reduced symptoms of vaginal-dryness (OR=0.4, 95%CI=0.2-0.9, p=0.025).
Conclusion: Data show high RRESDO acceptability particularly in women concerned about sexual-dysfunction. Although RRSO satisfaction remains high, regret rates are much higher for premenopausal women than postmenopausal women. HRT-use following premenopausal RRSO does not increase satisfaction and reduces vaginal dryness.
AB - Objective: To determine risk-reducing-early-salpingectomy-and-delayed-oophorectomy (RRESDO) acceptability and effect of surgical prevention on menopausal sequelae/satisfaction/regret in women at increased ovarian-cancer (OC) risk.
Design: Multicentre, cohort, questionnaire-study (IRSCTN:12310993).
Setting: United-Kingdom (UK).
Population: OC unaffected UK-women ≥18years, at increased OC-risk, with/without previous RRSO, ascertained through specialist familial-cancer/genetic-clinics and BRCA support-groups.
Methods: Participants completed a 39-item questionnaire. Baseline characteristics were described using descriptive statistics. Logistic/linear-regression models analysed impact of variables on RRESDO acceptability and health-outcomes.
Main Outcomes: RRESDO acceptability, menopausal-sequelae, satisfaction/regret.
Results: 346 of 683 participants underwent risk-reducing salpingo-oophorectomy (RRSO) and 337 did not. 69.1% (181/262) premenopausal women who had not undergone RRSO found it acceptable to participate in a research study offering RRESDO. Premenopausal women concerned about sexual-dysfunction were more likely (OR=2.9, 95%CI=1.2-7.7, p=0.025) to find RRESDO acceptable. Women experiencing sexual-dysfunction after premenopausal-RRSO were more likely to find RRESDO acceptable in retrospect (OR=5.3, 95%CI=1.2-27.5, p<0.031). 88.8%(143/161) premenopausal versus 95.2%(80/84) postmenopausal women who underwent RRSO respectively were satisfied with their decision. 9.4%(15/160) premenopausal and 1.2%(1/81) postmenopausal women who underwent RRSO regretted their decision. HRT-uptake in breast-cancer (BC) unaffected premenopausal individuals was 74.1% (80/108). ). HRT-use did not significantly affect satisfaction/regret levels but reduced symptoms of vaginal-dryness (OR=0.4, 95%CI=0.2-0.9, p=0.025).
Conclusion: Data show high RRESDO acceptability particularly in women concerned about sexual-dysfunction. Although RRSO satisfaction remains high, regret rates are much higher for premenopausal women than postmenopausal women. HRT-use following premenopausal RRSO does not increase satisfaction and reduces vaginal dryness.
KW - BRCA
KW - risk reducing early salpingectomy with delayed oophorectomy
KW - acceptability
KW - ovarian cancer
M3 - Article
SN - 1470-0328
JO - BJOG
JF - BJOG
ER -
