Chandrasekaran, D;
Menon, U;
Evans, G;
Crawford, R;
Saridogan, E;
Jacobs, C;
Tischkowitz, M;
... Manchanda, R; + view all
(2015)
Risk reducing salpingectomy and delayed oophorectomy in high risk women: views of cancer geneticists, genetic counsellors and gynaecological oncologists in the UK.
Familial Cancer
, 14
(4)
pp. 521-530.
10.1007/s10689-015-9823-y.
Preview |
Text
BGCS CGG RRSDO paper_famcancer_Revision_vF3-accepted.pdf - Accepted Version Download (196kB) | Preview |
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.
Type: | Article |
---|---|
Title: | Risk reducing salpingectomy and delayed oophorectomy in high risk women: views of cancer geneticists, genetic counsellors and gynaecological oncologists in the UK |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1007/s10689-015-9823-y |
Publisher version: | http://doi.org/10.1007/s10689-015-9823-y |
Language: | English |
Additional information: | © Springer Science+Business Media Dordrecht 2015. The final publication is available at Springer via http://dx.doi.org/10.1007/s10689-015-9823-y |
Keywords: | Science & Technology, Life Sciences & Biomedicine, Oncology, Genetics & Heredity, Risk reducing salpingectomy, Delayed oophorectomy, RRSDO, BRCA, High-risk, Ovarian cancer, BRCA2 MUTATION CARRIERS, FAMILIAL OVARIAN-CANCER, EARLY BILATERAL OOPHORECTOMY, FALLOPIAN-TUBE, PROPHYLACTIC SALPINGECTOMY, UNDERWENT OOPHORECTOMY, RESPONSE RATES, BREAST, PENETRANCE, MORTALITY |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health |
URI: | https://discovery.ucl.ac.uk/id/eprint/1477077 |
Archive Staff Only
![]() |
View Item |