Quality-of-life effects of prophylactic salpingo-oophorectomy versus gynecologic screening among women at increased risk of hereditary ovarian cancer.
OBJECTIVE
Recommendations for women at high risk of ovarian cancer include periodic gynecologic screening (GS) and prophylactic bilateral salpingo-oophorectomy (PBSO). The aim of the current study was to determine the quality-of-life (QOL) effects of PBSO versus GS.


METHODS
Questionnaire data were obtained from 846 high-risk women who had participated in this nationwide, cross-sectional, observational study. Forty-four percent of the women had undergone PBSO, and 56% had opted for GS. Topics addressed by the questionnaire included generic QOL, cancer-specific distress, endocrine symptoms, and sexual functioning.


RESULTS
No statistically significant between-group differences were observed in generic QOL (Short Form-36), with women in both the PBSO and GS groups scoring similarly to the general population. Compared with GS, PBSO was associated with fewer breast and ovarian cancer worries (P < .001) and more favorable cancer risk perception (P < .05). However, the PBSO group reported significantly more endocrine symptoms (P < .001) and worse sexual functioning (P < .05) than the GS group. Eighty-six percent of women would choose PBSO again, and 63% would recommend it to a friend with familial risk of ovarian cancer.


CONCLUSIONS
PBSO had no measurable adverse impact on generic QOL of high-risk women. The favorable effects of PBSO in terms of reduced cancer worries and low perceived cancer risk need to be weighed against the increase in endocrine and sexual symptoms. Balanced information will help clinicians and high-risk women to make informed decisions about the optimal preventive health strategy.
Madalinska
Joanna B
JB
Division of Psychosocial Research and Epidemiology, Department of Gynecology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Hollenstein
Judith
J
Bleiker
Eveline
E
van Beurden
Marc
M
Valdimarsdottir
Heiddis B
HB
Massuger
Leon F
LF
Gaarenstroom
Katja N
KN
Mourits
Marian J E
MJ
Verheijen
René H M
RH
van Dorst
Eleonora B L
EB
van der Putten
Hans
H
van der Velden
Ko
K
Boonstra
Henk
H
Aaronson
Neil K
NK
D000328:Adult; D000368:Aged; D001007:Anxiety; D003430:Cross-Sectional Studies; D003657:Decision Making; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control* / Q000523:psychology; D010052:Ovariectomy / Q000009:adverse effects; D011788:Quality of Life; D018570:Risk Assessment; D013315:Stress, Psychological