Psychological outcomes of familial ovarian cancer screening: No evidence of long-term harm

Psychological outcomes of familial ovarian cancer screening: No evidence of long-term harm

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 Highlights

► Abnormal results of familial ovarian cancer screening may raise women's concerns in the short-term but not in the longer-term.
► Women receiving abnormal test results are more likely to withdraw from screening, primarily for salpingo-oophorectomy.
► Decision support is needed for women who are considering options for managing their risk of familial ovarian cancer.

 Abstract

Objectives

Ovarian cancer screening for women at increased genetic risk in the UK involves 4-monthly CA125 tests and annual ultrasound, with further tests prompted by an abnormal result. The study evaluated the longer-term psychological and behavioural effects of frequent ovarian screening.

Methods

Women completed T1 questionnaires before their first routine 4-monthly CA125 test, and T2 follow-up questionnaires one week after their result. Women with abnormal results completed a further questionnaire one week after return to routine screening (T3 primary end-point). T4 questionnaires were sent at nine months. Measures included cancer distress, general anxiety/depression, reassurance, and withdrawal from screening.

Results

A total 1999 (62%) of 3224 women completed T1 questionnaires. T2 questionnaires were completed by 1384/1609 participants (86%): 1217 (89%) with normal results and 167/242 (69%) with abnormal results. T3 questionnaires were completed by 141/163 (87%) women, with 912/1173 (78%) completing T4 questionnaires. Analysis of covariance indicated that, compared to women with normal results, women with abnormal results reported moderate cancer distress (F = 27.47, p ≤ .001, η² = 0.02) one week after their abnormal result and were significantly more likely to withdraw from screening (OR = 4.38, p ≤ .001). These effects were not apparent at T3 or T4. The effect of screening result on general anxiety/depression or overall reassurance was not significant.

Conclusions

Women participating in frequent ovarian screening who are recalled for an abnormal result may experience transient cancer-specific distress, which may prompt reconsideration of risk management options. Health professionals and policy makers may be reassured that frequent familial ovarian screening does not cause sustained psychological harm.

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Highlights

► Abnormal results of familial ovarian cancer screening may raise women's concerns in the short-term but not in the longer-term.
► Women receiving abnormal test results are more likely to withdraw from screening, primarily for salpingo-oophorectomy.
► Decision support is needed for women who are considering options for managing their risk of familial ovarian cancer.