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Prevention of gynaecologic cancer
179 Cancer worry among BRCA1/2 pathogenic variant carriers choosing surgery to prevent tubal/ovarian cancer
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  1. M Van Bommel1,
  2. M Steenbeek2,
  3. J Inthout3,
  4. R Hermens4,
  5. N Hoogerbrugge5,
  6. H Van Doorn6,
  7. M Mourits7,
  8. M Van Beurden8,
  9. R Zweemer9,
  10. K Gaarenstroom10,
  11. B Slangen11,
  12. M Brood-van Zanten8,8,
  13. C Vos12,
  14. J Piek13,
  15. L Van Lonkhuijzen8,
  16. M Apperloo14,
  17. S Coppus15,
  18. J Prins16,
  19. J Custers16 and
  20. J De Hullu1
  1. 1Radboud university medical center, Department of Obstetrics and Gynaecology, Nijmegen, Netherlands
  2. 2Radboud university medical center , Department of Obstetrics and Gynaecology, Nijmegen, Netherlands
  3. 3Radboud university medical center, Department for Health Evidence, Nijmegen, Netherlands
  4. 4Radboud university medical center, Scientific Institute for Quality of Healthcare, Nijmegen, Netherlands
  5. 5Radboud university medical center, Department of Human Genetics, Nijmegen, Netherlands
  6. 6Erasmus MC Cancer Clinic, Department of Gynaecology, Rotterdam, Netherlands
  7. 7University Medical Center Groningen, Department of Gynaecology, Groningen, Netherlands
  8. 8Center for Gynaecological Oncology Amsterdam , Amsterdam, Netherlands
  9. 9UMC Utrecht Cancer Center, Department of Obstetrics and Gynaecology, Utrecht, Netherlands
  10. 10Leiden University Medical Center, Department of Obstetrics and Gynaecology, Leiden, Netherlands
  11. 11Maastricht University Medical Center, Department of Obstetrics and Gynaecology, Maastricht , Netherlands
  12. 12Gynaecologic Oncologic Center South location Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
  13. 13Gynaecologic Oncologic Center South location Catharina Hospital, Department of Obstetrics and Gynaecology, Eindhoven, Netherlands
  14. 14Medical Centre Leeuwarden, Department of Obstetrics and Gynaecology, Leeuwarden, Netherlands
  15. 15Maxima Medical Center, Department of Obstetrics and Gynaecology, Veldhoven, Netherlands
  16. 16Radboud university medical center, Department of Medical Psychology, Nijmegen, Netherlands

Abstract

Introduction/Background*High cancer risks, as applicable to BRCA1 and BRCA2 pathogenic variant (PV) carriers, can induce significant cancer concerns. We examined the degree of cancer worry and the course of this worry among BRCA1/2-PV carriers opting for surgery to prevent ovarian cancer, and identified factors associated with high cancer worry.

Methodology Cancer worry was evaluated as part of the multicentre, prospective TUBA-study (NCT02321228) in which BRCA1/2-PV carriers choose between the standard risk-reducing salpingo-oophorectomy or a novel strategy, risk-reducing salpingectomy with delayed oophorectomy. The Cancer Worry Scale was obtained before and three and twelve months after surgery. Cancer worry patterns were analysed using latent class growth analysis and factors associated with cancer worry were identified with regression analysis.

Result(s)*Of all 577 BRCA1/2-PV carriers, 320 (55.5%) had high (≥14) cancer worry pre-surgery and 70.2% had higher cancer worry pre-surgery than post-surgery. Based on the course of cancer worry, BRCA1/2-PV carriers could be classified into three groups: persistently low cancer worry (56.4%), persistently high cancer worry (6.3%), and fluctuating cancer worry that mainly declined over time (37.3%). Factors associated with persistently high cancer concerns were: age below 35 (BRCA1) or 40 (BRCA2) years, unemployment, previous breast cancer diagnosis, lower education and more recent diagnosis with the BRCA-PV.

Conclusion*High cancer worry is common among BRCA1/2-PV carriers and mainly declines after risk-reducing surgery. However, cancer worry remains high in 6% of the women and they should be identified and offered support. It should be realized that in this group, surgery does not reduce cancer concerns.

https://doi.org/10.1136/ijgc-2021-ESGO.541

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