New strategies in ovarian cancer: uptake and experience of women at high risk of ovarian cancer who are considering risk-reducing salpingo-oophorectomy

Clin Cancer Res. 2010 Nov 1;16(21):5094-106. doi: 10.1158/1078-0432.CCR-09-2953. Epub 2010 Sep 9.

Abstract

Here, we review factors associated with uptake of risk-reducing salpingo-oophorectomy by women at increased hereditary risk for ovarian cancer, as well as quality of life issues following surgery. Forty-one research studies identified through PubMed and PsychInfo met inclusion criteria. Older age, having had children, a family history of ovarian cancer, a personal history of breast cancer, prophylactic mastectomy, and BRCA1/2 mutation carrier status increase the likelihood of undergoing surgery. Psychosocial variables predictive of surgery uptake include greater perceived risk of ovarian cancer and cancer-related anxiety. Most women report satisfaction with their decision to undergo surgery and both lower perceived ovarian cancer risk and less cancer-related anxiety as benefits. Hormonal deprivation is the main disadvantage reported, particularly by premenopausal women who are not on hormonal replacement therapy (HRT). The evidence is mixed about satisfaction with the level of information provided prior to surgery, although generally, women report receiving insufficient information about the pros and cons of HRT. These findings indicate that when designing decision aids, demographic, medical history, and psychosocial variables need to be addressed in order to facilitate quality decision making.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Carcinoma / etiology
  • Carcinoma / prevention & control
  • Carcinoma / therapy*
  • Choice Behavior
  • Decision Making / physiology
  • Female
  • Hormone Replacement Therapy / adverse effects
  • Hormone Replacement Therapy / statistics & numerical data
  • Humans
  • Medical Oncology / education
  • Medical Oncology / methods
  • Medical Oncology / trends*
  • Ovarian Neoplasms / etiology
  • Ovarian Neoplasms / prevention & control
  • Ovarian Neoplasms / therapy*
  • Ovariectomy / education
  • Ovariectomy / methods
  • Ovariectomy / statistics & numerical data*
  • Patient Education as Topic
  • Risk Factors
  • Risk Reduction Behavior*
  • Salpingostomy / education
  • Salpingostomy / methods
  • Salpingostomy / statistics & numerical data*