A Psychological Perspective on Factors Predicting Prophylactic Salpingo-Oophorectomy in a Sample of Italian Women from the General Population. Results from a Hypothetical Study in the Context of BRCA Mutations.
The aim of this study was to assess attitudes toward ovarian cancer risk management options for BRCA mutation carriers in healthy Italian women, and to identify predictors of the preference for risk reducing salpingo-oophorectomy (RRSO) over surveillance. One hundred eighty-one women aged 30-45 completed a questionnaire about preferences, knowledge, risk perception, and socio-demographic information. Participants were randomly presented with a pamphlet about BRCA1 or BRCA2 mutation-specific testing, consequences of testing and preventive options for carriers, and they were stratified by having children or not and by age group. Surveillance was the preferred option (64.6%), followed by RRSO (24.3%). Although RRSO is the only effective strategy available to BRCA carriers, most healthy women faced for the first time with this option may not consider it as their preferred choice. Predictors associated with a higher likelihood to prefer surgery over surveillance were: knowing that life expectancy is longer with surgery, perceived comprehension of the consequences of testing, previous knowledge about BRCA testing, anticipated worry about developing cancer, and feelings of risk. Childbearing intentions and the effect of childbearing intentions on choice were associated with a lower preference for surgery. Further research is needed to confirm the role of the factors identified in this study in order to promote informed decision-making about RRSO.
Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131, Padova, Italy. teresa.gavaruzzi@unipd.it.
Teresa
T
Gavaruzzi
Department of Humanities, University of Ferrara, Ferrara, Italy.
Alessandra
A
Tasso
Unit of Hereditary Cancer, IRCCS AOU San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
Marzena
M
Franiuk
Unit of Hereditary Cancer, IRCCS AOU San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
Liliana
L
Varesco
Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131, Padova, Italy.|Center for Cognitive Neuroscience, University of Padova, Padova, Italy.
Lorella
L
Lotto
D000328:Adult; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006579:Heterozygote; D006801:Humans; D007558:Italy; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000601:surgery*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D058994:Salpingectomy; D000074868:Salpingo-oophorectomy / Q000706:statistics & numerical data*
BRCA mutation; Decision making; Genetic counseling; Prophylactic surgical procedures; Risk-reducing salpingo-oophorectomy (RRSO)