title: Psychosocial factors and uptake of risk-reducing salpingo-oophorectomy in women at high risk for ovarian cancer.
abstract: Bilateral risk-reducing salpingo-oophorectomy (RRSO) has been shown to significantly reduce the risk of ovarian cancer. This study assessed factors predicting uptake of RRSO. Women participating in a large multiple-case breast cancer family cohort study who were at increased risk for ovarian and fallopian tube cancer (i.e. BRCA1 or BRCA2 mutation carrier or family history including at least one first- or second-degree relative with ovarian or fallopian tube cancer), with no personal history of cancer and with at least one ovary in situ at cohort enrolment, were eligible for this study. Women who knew they did not carry the BRCA1 or BRCA2 mutation segregating in their family (true negatives) were excluded. Sociodemographic, biological and psychosocial factors, including cancer-specific anxiety, perceived ovarian cancer risk, optimism and social support, were assessed using self-administered questionnaires and interviews at cohort enrolment. RRSO uptake was self-reported every three years during systematic follow-up. Of 2,859 women, 571 were eligible. Mean age was 43.3 years; 62 women (10.9 %) had RRSO a median of two years after cohort entry. Factors predicting RRSO were: being parous (OR 3.3, p = 0.015); knowing one's mutation positive status (OR 2.9, p < 0.001) and having a mother and/or sister who died from ovarian cancer (OR 2.5, p = 0.013). Psychological variables measured at cohort entry were not associated with RRSO. These results suggest that women at high risk for ovarian cancer make decisions about RRSO based on risk and individual socio-demographic characteristics, rather than in response to psychological factors such as anxiety.
authors.affiliation: Psychosocial Research Group, Department of Medical Oncology, Prince of Wales Hospital Randwick, Dickinson 3, Randwick, NSW, 2031, Australia. b.meiser@unsw.edu.au
authors.forename: Bettina
authors.initials: B
authors.lastname: Meiser
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Price
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.forename: Janan
authors.initials: J
authors.lastname: Karatas
authors.forename: Judy
authors.initials: J
authors.lastname: Wilson
authors.forename: Louise
authors.initials: L
authors.lastname: Heiniger
authors.forename: Brandi
authors.initials: B
authors.lastname: Baylock
authors.forename: Margaret
authors.initials: M
authors.lastname: Charles
authors.forename: Sue-Anne
authors.initials: SA
authors.lastname: McLachlan
authors.forename: Kelly-Anne
authors.initials: KA
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery*; D015331:Cohort Studies; D005185:Fallopian Tube Neoplasms / Q000523:psychology / Q000601:surgery*; 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 / Q000235:genetics / Q000523:psychology* / Q000601:surgery; D010052:Ovariectomy / Q000523:psychology*; D010053:Ovary / Q000601:surgery*; D011446:Prospective Studies; D011584:Psychology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D058994:Salpingectomy / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult