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2022-RA-1488-ESGO Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer
  1. Lara Terra,
  2. Philippe Lee Meeuw Kjoe,
  3. Joost Agelink van Rentergem Zandvliet,
  4. Maarten Beekman,
  5. Sanne Schagen,
  6. Flora van Leeuwen,
  7. HARMOny study group
  1. Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, Netherlands


Introduction/Background Several studies reported that bilateral oophorectomy before menopause is associated with cognitive impairment. However, these studies had methodological limitations. We examined the effect of a premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer on objective and subjective cognition at least 10 years after RRSO.

Methodology The study population consisted of women (66% BRCA1/2 mutation carriers) who underwent either a premenopausal RRSO ≤ age 45 (n=436) or a postmenopausal RRSO ≥ age 54 (n=205) and were older than 54 years at study. Participants completed an online cognitive test battery and a questionnaire on subjective cognition. We examined the influence of RRSO on objective and subjective cognition of women with a premenopausal RRSO compared to women with a postmenopausal RRSO, using multivariable regression analyses, adjusting for age, education, breast cancer, hormone replacement therapy, depression and cardiovascular risk factors. We performed subgroup analyses comparing an early premenopausal RRSO (RRSO ≤ age 40, recommended to BRCA1 mutation carriers) versus a later premenopausal RRSO (RRSO between ages 41–45, recommended to BRCA2 mutation carriers).

Abstract 2022-RA-1488-ESGO Figure 1

Results After adjustment, women with a premenopausal RRSO (mean time since RRSO 18.2 years) performed similarly on objective cognitive tests as women with a postmenopausal RRSO (mean time since RRSO 11.9 years). However, they more frequently reported problems with reasoning (odds ratio (OR) 1.8 (95% confidence interval (95%CI) 1.1–3.1)) and multitasking (OR 1.9 (95%CI 1.1–3.4)) than women with a postmenopausal RRSO. This difference between groups disappeared in an analysis restricted to women of comparable ages (60–70 years). We found no objective cognitive differences between women with a RRSO between ages 41–45 and women with a RRSO before age 40.

Conclusion Reassuringly, approximately 18 years after RRSO, we found no association between premenopausal RRSO and objective cognition.

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