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 Journal Article


Authors: Mai, P. L.; Piedmonte, M.; Han, P. K.; Moser, R. P.; Walker, J. L.; Rodriguez, G.; Boggess, J.; Rutherford, T. J.; Zivanovic, O.; Cohn, D. E.; Thigpen, J. T.; Wenham, R. M.; Friedlander, M. L.; Hamilton, C. A.; Bakkum-Gamez, J.; Olawaiye, A. B.; Hensley, M. L.; Greene, M. H.; Huang, H. Q.; Wenzel, L.
Article Title: 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
Abstract: 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 (p < 0.0001), more likely to carry deleterious BRCA1/2 mutations (p < 0.0001), perceive RRSO as effective, be more concerned about surgical harms and OCS limitations, and report higher perceived OC risk and OC-related worry. OCS participants were more likely to perceive screening as effective, be more concerned about menopausal symptoms, infertility, and loss of femininity, and report better overall quality-of-life. Twenty-four percent of participants believed they would definitely develop OC, and half estimated their lifetime OC risk as > 50%, 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. © 2017
Journal Title: Gynecologic Oncology
Volume: 145
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2017-04-01
Start Page: 122
End Page: 129
Language: English
DOI: 10.1016/j.ygyno.2017.02.008
PROVIDER: scopus
PMCID: PMC5359045
PUBMED: 28190649
DOI/URL:
Notes: Article -- Export Date: 4 April 2017 -- Source: Scopus
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MSK Authors
  1. Oliver Zivanovic
    131 Zivanovic
  2. Martee L Hensley
    229 Hensley