Abstract |
Risk-reducing- salpingectomy and Delayed- Oophorectomy (RRSDO) is being proposed as a two-staged approach in place of RRSO to reduce the risks associated with premature menopause in high-risk women. We report on the acceptability/attitude of UK health professionals towards RRSDO. An anonymised web-based survey was sent to UK Cancer Genetics Group (CGG) and British Gynaecological Cancer Society (BGCS) members to assess attitudes towards RRSDO. Baseline characteristics were described using descriptive statistics. A Chi square test was used to compare categorical, Kendal-tau-b test for ordinal and Mann-Whitney test for continuous variables between two groups. 173/708 (24.4%) of invitees responded. 71% respondents (CGG = 57%/BGCS = 83%, p = 0.005) agreed with the tubal hypothesis for OC, 55% (CGG = 42%/BGCS = 66%, p = 0.003) had heard of RRSDO and 48% (CGG = 46%/BGCS = 50%) felt evidence was not currently strong enough for introduction into clinical practice. However, 60% respondents' (CGG = 48%/BGCS = 71%, p = 0.009) favoured offering RRSDO to high-risk women declining RRSO, 77% only supported RRSDO within a clinical trial (CGG = 78%/BGCS = 76%) and 81% (CGG = 76%/BGCS = 86%) advocated a UK-wide registry. Vasomotor symptoms (72%), impact on sexual function (63%), osteoporosis (59%), hormonal- therapy (55%) and subfertility (48%) related to premature menopause influenced their choice of RRSDO. Potential barriers to offering the two-stage procedure included lack of data on precise level of benefit (83%), increased surgical morbidity (79%), loss of breast cancer risk reduction associated with oophorectomy (68%), need for long-term follow-up (61%) and a proportion not undergoing DO (66%). There were variations in perception between BGCS/CGG members which are probably attributable to differences in clinical focus/expertise between these two groups. Despite concerns, there is reasonable support amongst UK clinicians to offering RRSDO to premenopausal high-risk women wishing to avoid RRSO, within a prospective clinical trial.
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Authors | Dhivya Chandrasekaran, Usha Menon, Gareth Evans, Robin Crawford, Ertan Saridogan, Chris Jacobs, Marc Tischkowitz, Elly Brockbank, Jatinder Kalsi, Davor Jurkovic, Ranjit Manchanda |
Journal | Familial cancer
(Fam Cancer)
Vol. 14
Issue 4
Pg. 521-30
(Dec 2015)
ISSN: 1573-7292 [Electronic] Netherlands |
PMID | 26178205
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- BRCA1 Protein
- BRCA1 protein, human
- BRCA2 Protein
- BRCA2 protein, human
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Topics |
- Attitude of Health Personnel
- BRCA1 Protein
(genetics)
- BRCA2 Protein
(genetics)
- Female
- Genetic Counseling
- Genetic Predisposition to Disease
- Germ-Line Mutation
(genetics)
- Humans
- Ovarian Neoplasms
(genetics, prevention & control, psychology)
- Ovariectomy
(methods, psychology)
- Practice Patterns, Physicians'
- Prognosis
- Risk Reduction Behavior
- Salpingectomy
(methods, psychology)
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