Showing posts with label prophylactic surgery. Show all posts
Showing posts with label prophylactic surgery. Show all posts
Saturday, May 05, 2012
paywalled: Prophylactic oophorectomy rates in relation to a guideline update on referral to genetic counseling
Prophylactic oophorectomy rates in relation to a guideline update on referral to genetic counseling: Publication year: 2012
Source: Gynecologic Oncology
Objective We sought to determine whether prophylactic oophorectomy rates changed after the introduction of a 2007 health plan clinical guideline recommending systematic referral to a genetic counselor for women with a personal or family history suggestive of an inherited susceptibility to breast/ovarian cancer.
Methods We conducted a retrospective cohort study of female members of Group Health, an integrated delivery system in Washington State. Subjects were women aged ≥35years during 2004–2009 who reported a personal or family history consistent with an inherited susceptibility to breast/ovarian cancer. Personal and family history information was collected on a questionnaire completed when the women had a mammogram. We ascertained oophorectomies from automated claims data and determined whether surgeries were prophylactic by medical chart review.....
Results Prophylactic oophorectomy rates were relatively unchanged after compared to before the guideline change, 1.0 versus 0.8/1,000 person-years, (IRR=1.2; 95% CI: 0.7-2.0), whereas bilateral oophorectomy rates for other indications decreased. Genetic counseling receipt rates doubled after the guideline change (95% CI: 1.7-2.4) from 5.1 to 10.2/1,000 person-years. During the study, bilateral oophorectomy rates were appreciably greater in women who saw a genetic counselor compared to those who did not regardless of whether they received genetic testing as part of their counseling.
Conclusion A doubling in genetic counseling receipt rates lends support to the idea that the guideline issuance contributed to sustained rates of prophylactic oophorectomies in more recent years.
add your opinions
family history
,
genetic counseling
,
genetic testing
,
oophorectomy
,
ovarian cancer prevention
,
prophylactic surgery
,
surgery
Saturday, March 10, 2012
Monday, March 05, 2012
Long-term outcomes of BRCA1/BRCA2 testing: risk reduction and surveillance (risk reducing surgery - breasts/bilateral salpino-oophorectomies)
Abstract
BACKGROUND:
For BRCA1/BRCA2 gene testing to benefit public health, mutation carriers must initiate appropriate risk management strategies. There has been little research examining the long-term use and prospective predictors of the full range of risk management behaviors among women who have undergone BRCA1/2 testing. We evaluated long-term uptake and predictors of risk-reducing mastectomy (RRM), risk-reducing bilateral salpingo-oophorectomy (RRBSO), chemoprevention, and cancer screening among women at a mean of 5.3 years after testing.METHODS:
The study participants comprised 465 women who underwent BRCA1/2 testing. Prior to genetic counseling, we measured family/personal cancer history, sociodemographics, perceived risk, cancer-specific distress, and general distress. We contacted patients at a mean of 5.3 years after testing to measure use of RRM, RRBSO, chemoprevention, and breast and ovarian cancer screening.RESULTS:
Among participants with intact breasts and/or ovaries at the time of testing, BRCA1/2 carriers were significantly more likely to obtain RRM (37%) and RRBSO (65%) compared with women who received uninformative (RRM, 6.8%; RRBSO, 13.3%) or negative (RRM, 0%; RRBSO, 1.9%) results. Among carriers, precounseling anxiety was associated with subsequent uptake of RRM. RRO was predicted by age. Carriers were also more likely have used breast cancer chemoprevention and have undergone magnetic resonance imaging screening.CONCLUSION:
This prospective evaluation of the uptake and predictors of long-term management outcomes provides a clearer picture of decision making in this population. At a mean of 5.3 years after testing, more than 80% of carriers had obtained RRM, RRBSO, or both, suggesting that BRCA1/2 testing is likely to have a favorable effect on breast and ovarian cancer outcomes.
add your opinions
BRCA
,
prophylactic surgery
,
risk reducing surgery
Fallopian Tube Removal as a Method of Ovarian Cancer Prevention: A Descriptive Study - Full Text View - ClinicalTrials.gov
Fallopian Tube Removal as a Method of Ovarian Cancer Prevention: A Descriptive Study
This study is currently recruiting participants.
Verified February 2012 by University of Washington
First Received on February 28, 2012. Last Updated on March 2, 2012 History of Changes
Purpose
Purpose
The purpose of this study is to better understand why women choose to have their fallopian tubes removed as a method for ovarian cancer prevention. This will be done through a paper questionnaire and phone interviews. The investigators hope to gain information that will allow us to better counsel women about ovarian cancer prevention.
Sponsor: | University of Washington |
---|---|
Information provided by (Responsible Party): | Elizabeth Swisher, University of Washington |
ClinicalTrials.gov Identifier: | NCT01544049 |
add your opinions
cancer prevention
,
clinical trials
,
fallopian tubes
,
prophylactic surgery
,
surgery
Tuesday, February 28, 2012
abstract: Lynch syndrome: clinical, pathological, and genetic insights (prophylactic surgery - female)
Lynch syndrome: clinical, pathological, and genetic insights:
Conclusions
Therefore, taking the risk reduction into account, extended surgery at the time of the first colon primary should at least
be discussed, if not recommended. Also, prophylactic hysterectomy and bilateral oophorectomy at the time of a colorectal primary
should be recommended if family planning has been completed.
add your opinions
bilateral oophorectomy
,
hysterectomy
,
Lynch Syndrome
,
prophylactic surgery
Wednesday, February 22, 2012
abstract: Risk-reducing bilateral salpingo-oophorectomy and sexual health: a qualitative study
Conclusion:
This study provided a nuanced view of sexual health in women following RRBSO that was not captured by self-report questionnaires. Women with preoperative knowledge of post-BSO sexual side effects report being more prepared for surgery, and experience less sexual distress following their BSO.
add your opinions
prophylactic surgery
,
risk reducing surgery
,
sexual health
Tuesday, January 24, 2012
Jan 2012 abstract: Long-term follow-up of Jewish women with a BRCA1 and BRCA2 mutation who underwent population genetic screening
Blogger's Note: in this study longterm followup = 2 years
Abstract
There
are two mutations in BRCA1 and one in BRCA2, which are present in up to
2.5% of Jewish women. Population genetic testing
for Jewish women has been proposed; however, it is unclear
how this would impact the uptake of cancer prevention options and
psychosocial functioning in women with a positive result.
Two thousand and eighty unselected Jewish women were tested for
the Jewish BRCA mutations, and 1.1% were positive.
Cancer-related distress was measured before testing, and at 1 and
2 years
post-testing. Information on uptake of cancer risk reduction
options was collected at 2 years. Breast and ovarian cancer risks
were estimated using BRCAPRO. Within 2 years of receiving a
positive result, 11.1% of women had prophylactic mastectomy, and
89.5% had a prophylactic oophorectomy. The mean breast
cancer risk was estimated to be 37.2% at time of testing, compared
to 20.9% at 2 years post-testing. The mean ovarian cancer
risk was estimated to be 24.5% at time of testing, compared to 7.5%
at 2 years following testing. Distress decreased between 1
and 2 years for women with prophylactic mastectomy and oophorectomy
(P = 0.02), and for women with prophylactic oophorectomy only (P = 0.04)
but not for those with neither surgery. The majority of Jewish women
with a BRCA mutation identified through a population
screening elected prophylactic oophorectomy, but a few had a
prophylactic mastectomy. Uptake of either surgery resulted in
decreased distress. Provision of population BRCA testing
resulted in reduced risks of breast and ovarian cancers in women
with a mutation.
Keywords BRCA1 – BRCA2 – Breast cancer – Genetic testing – Jewish
add your opinions
BRCA
,
breast cancer risk
,
distress
,
Jewish
,
ovarian cancer risk
,
prophylactic surgery
Tuesday, August 10, 2010
Making comparative effectiveness work in cancer care - Cancer Network
Note: discusses cost eg. BRCA's - surgery vs surveillance
add your opinions
BRCA
,
comparative effectiveness research
,
costs
,
prophylactic surgery
,
surveillance
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