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.
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