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Psychosocial factors and uptake of risk-reducing salpingo-oophorectomy in women at high risk for ovarian cancer

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Abstract

Bilateral risk-reducing salpingo-oophorectomy (RRSO) has been shown to significantly reduce the risk of ovarian cancer. This study assessed factors predicting uptake of RRSO. Women participating in a large multiple-case breast cancer family cohort study who were at increased risk for ovarian and fallopian tube cancer (i.e. BRCA1 or BRCA2 mutation carrier or family history including at least one first- or second-degree relative with ovarian or fallopian tube cancer), with no personal history of cancer and with at least one ovary in situ at cohort enrolment, were eligible for this study. Women who knew they did not carry the BRCA1 or BRCA2 mutation segregating in their family (true negatives) were excluded. Sociodemographic, biological and psychosocial factors, including cancer-specific anxiety, perceived ovarian cancer risk, optimism and social support, were assessed using self-administered questionnaires and interviews at cohort enrolment. RRSO uptake was self-reported every three years during systematic follow-up. Of 2,859 women, 571 were eligible. Mean age was 43.3 years; 62 women (10.9 %) had RRSO a median of two years after cohort entry. Factors predicting RRSO were: being parous (OR 3.3, p = 0.015); knowing one’s mutation positive status (OR 2.9, p < 0.001) and having a mother and/or sister who died from ovarian cancer (OR 2.5, p = 0.013). Psychological variables measured at cohort entry were not associated with RRSO. These results suggest that women at high risk for ovarian cancer make decisions about RRSO based on risk and individual socio-demographic characteristics, rather than in response to psychological factors such as anxiety.

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Abbreviations

RRSO:

Risk-reducing salpingo-oophorectomy

HBOC:

Hereditary breast/ovarian cancer

kConFab:

Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer

BOADICEA:

Breast and ovarian analysis of disease incidence and carrier estimation algorithm

IES:

Impact of event scale

LOT:

Life orientation test

NHMRC:

National health and medical research council

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Acknowledgments

This study was funded by National Health and Medical Research Council (NHMRC) Project Grants No. 153824, 301930, 457316, 145684, 288704, and 454508 and by a National Breast Cancer Foundation and Cancer Australia Priority Driven Collaborative Cancer Research Grant (#628333). kConFab is supported by grants from the National Breast Cancer Foundation, the NHMRC, the Queensland Cancer Fund, the Cancer Councils of New South Wales, Victoria, Tasmania and South Australia, and the Cancer Foundation of Western Australia. Bettina Meiser receives a Career Development Award from the NHMRC. Phyllis Butow receives a Principal Research Fellowship from NHMRC. Kelly-Anne Phillips is the John Colebatch Clinical Research Fellow of the Cancer Council Victoria. We are very grateful to the many families who contribute to kConFab. We also wish to thank Lucy Stanhope, Kate Birch, Heather Thorne, Eveline Niedermayr, the kConFab research nurses and staff, and the heads and staff of the Family Cancer Clinics. We also thank Dr Adrian Bickerstaff and John Hopper for using the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) to calculate actual ovarian cancer risk.

Conflict of interest

The authors have no conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Psychosocial Research Group, Department of Medical Oncology, Prince of Wales Hospital Randwick, Dickinson 3, Randwick, NSW, 2031, Australia

    Bettina Meiser & Janan Karatas

  2. Prince of Wales Clinical School, University of New South Wales, Dickinson 3, Randwick, NSW, 2031, Australia

    Bettina Meiser & Janan Karatas

  3. Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia

    Melanie A. Price, Phyllis N. Butow, Judy Wilson, Louise Heiniger & Brandi Baylock

  4. School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia

    Margaret Charles

  5. Oncology Department, St Vincent’s Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia

    Sue-Anne McLachlan

  6. Department of Medicine, St Vincent’s Hospital, University of Melbourne, Melbourne, VIC, 3010, Australia

    Sue-Anne McLachlan & Kelly-Anne Phillips

  7. Division of Cancer Medicine, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Melbourne, VIC, 8006, Australia

    Kelly-Anne Phillips

  8. School of Population Health, University of Melbourne, Melbourne, VIC, 3010, Australia

    Kelly-Anne Phillips

  9. Sir Peter MacCallum Department of Oncology, University of Melbourne, Level 5, 161 Barry Street, Parkville, VIC, 3010, Australia

    Kelly-Anne Phillips

Authors
  1. Bettina Meiser
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  2. Melanie A. Price
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  3. Phyllis N. Butow
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  4. Janan Karatas
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  5. Judy Wilson
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  6. Louise Heiniger
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  7. Brandi Baylock
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  8. Margaret Charles
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  9. Sue-Anne McLachlan
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  10. Kelly-Anne Phillips
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Corresponding author

Correspondence to Bettina Meiser.

Additional information

Please see the Appendix section for “The kConFab Psychosocial group” members.

Appendix

Appendix

The kConFab Psychosocial group includes the following in addition to the authors listed above: Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia (B Bennett, K Tucker); Northern Sydney and Central Coast Area Health Service, Sydney, Australia (C. Tennant). The kConFab Clinical Follow-Up group includes the following in addition to authors listed above: Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Victoria, Australia (J. L. Hopper, R. L. Milne); Division of Cancer Medicine, Peter MacCallum Cancer Centre, Victoria, Australia (P. Weideman, L. Stanhope,); Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia (M. L. Friedlander); Familial Cancer Centre, Department of Medicine, University of Utah, Salt Lake City, Utah (D. Goldgar).

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Meiser, B., Price, M.A., Butow, P.N. et al. Psychosocial factors and uptake of risk-reducing salpingo-oophorectomy in women at high risk for ovarian cancer. Familial Cancer 12, 101–109 (2013). https://doi.org/10.1007/s10689-012-9585-8

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  • DOI: https://doi.org/10.1007/s10689-012-9585-8

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