title: Stopping ovarian cancer screening in BRCA1/2 mutation carriers: effects on risk management decisions & outcome of risk-reducing salpingo-oophorectomy specimens.
abstract: OBJECTIVE
  Ovarian cancer screening (OCS) for BRCA1/2 mutation carriers was stopped in our family cancer clinic in 2009 because of its ineffectiveness. The study objective was to investigate the effect of stopping OCS on the timing and uptake of risk-reducing salpingo-oophorectomy (RRSO) and on the percentage of occult cancers in the specimens.
  
  
  METHODS
  419 BRCA1/2 mutation carriers were recruited between January 1999 and June 2013. Uptake, timing and the outcome of the RRSO specimens before stopping OCS (period I) were compared to those after stopping OCS (period II).
  
  
  RESULTS
  The percentage of women undergoing RRSO within the recommended age range increased from 81% to 95%. Receiving DNA test results in period II independently predicted a shorter time interval to RRSO (hazard ratio: 2.48, 95% confidence interval: 1.81-3.39). The incidence of detecting occult cancers in RRSO specimens before and after stopping OCS was 1.3% and 1.8%, respectively, and was not statistically significantly different.
  
  
  CONCLUSIONS
  The presentation of risk management options to women may influence their decision. The increased patient awareness of the ineffectiveness of OCS could have led to a higher percentage of women undergoing RRSO and doing so more often within the recommended age range.
authors.affiliation: Departments of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: cmg.driel@umcg.nl.
authors.forename: Catheleine M G
authors.initials: CM
authors.lastname: van Driel
authors.affiliation: Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Geertruida H
authors.initials: GH
authors.lastname: de Bock
authors.affiliation: Departments of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Henriette J G
authors.initials: HJ
authors.lastname: Arts
authors.affiliation: Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Aisha S
authors.initials: AS
authors.lastname: Sie
authors.affiliation: Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: Hollema
authors.affiliation: Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Oosterwijk
authors.affiliation: Departments of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Marian J E
authors.initials: MJ
authors.lastname: Mourits
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009426:Netherlands; D010051:Ovarian Neoplasms / Q000235:genetics / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D010052:Ovariectomy / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012308:Risk Management; D058994:Salpingectomy / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Bilateral ovariectomy; Genes, BRCA1; Genes, BRCA2; Ovarian neoplasms/prevention & control; Risk reduction behavior; Time factors