title: The impact of risk-reducing gynaecological surgery in premenopausal women at high risk of endometrial and ovarian cancer due to Lynch syndrome.
abstract: Women with Lynch syndrome (LS) have a significantly increased lifetime risk of endometrial cancer (40-60 %) and ovarian cancer (7-12 %). Currently there is little evidence to support the efficacy of screening for the early detection of these cancers. Another option is risk-reducing hysterectomy and/or bilateral salpingo-oophorectomy (BSO). Research on the impact of BSO in premenopausal women with a non-LS associated family history cancer has generally shown that women have a high level of satisfaction about their decision to undergo surgery. However, debilitating menopausal symptoms and sexual dysfunction are common post-surgical problems. We used a mixed methods study to explore the impact of risk-reducing gynaecological surgery in women with LS: 24 women were invited to take part; 15 (62.5 %) completed validated questionnaires and 12 (50 %) participated in semi-structured interviews. Our results suggest that risk reducing surgery does not lead to significant psychological distress and the women tend not to think or worry much about developing cancer. However, they tend to be distressed about the physical and somatic symptoms associated with menopause; their social well-being is somewhat affected, but sexual difficulties are minimal. The women reported being overwhelmingly satisfied with their decision to have surgery and with the quality of information they received prior to the operation. However, they felt underprepared for menopausal symptoms and received conflicting advice about whether or not to use HRT. Recommendations from the study include that professionals discuss the menopause, its side effects and HRT in detail prior to surgery.
authors.affiliation: Department of Psychology, Babes-Bolyai University, No. 37 Republicii Street, 400015, Cluj-Napoca, Romania, ramonamoldovan@psychology.ro.
authors.forename: Ramona
authors.initials: R
authors.lastname: Moldovan
authors.forename: Sianan
authors.initials: S
authors.lastname: Keating
authors.forename: Tara
authors.initials: T
authors.lastname: Clancy
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000235:genetics / Q000517:prevention & control*; D005069:Evaluation Studies as Topic; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000523:psychology*; D007407:Interviews as Topic; D055847:Lynch Syndrome II / Q000150:complications; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy / Q000009:adverse effects / Q000523:psychology*; D017060:Patient Satisfaction; D017697:Premenopause; D065286:Prophylactic Surgical Procedures / Q000009:adverse effects / Q000523:psychology*; D058994:Salpingectomy / Q000009:adverse effects / Q000523:psychology*; D011795:Surveys and Questionnaires