Cancer worry among BRCA1/2 pathogenic variant carriers choosing surgery to prevent tubal/ovarian cancer: course over time and associated factors.

Autor: van Bommel MHD; Department of Obstetrics and Gynaecology, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. Majke.vanBommel@radboudumc.nl., Steenbeek MP; Department of Obstetrics and Gynaecology, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands., IntHout J; Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands., Hermens RPMG; Scientific Institute for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands., Hoogerbrugge N; Department of Human Genetics, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands., Harmsen MG; Department of Obstetrics and Gynaecology, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands., van Doorn HC; Department of Gynaecology, Erasmus MC Cancer Clinic, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands., Mourits MJE; Department of Gynaecologic Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands., van Beurden M; Center for Gynaecological Oncology Amsterdam (CGOA), Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands., Zweemer RP; Department of Gynaecological Oncology, UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., Gaarenstroom KN; Department of Obstetrics and Gynaecology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands., Slangen BFM; Department of Obstetrics and Gynaecology, Maastricht University Medical Center, GROW-School for Oncology and Developmental Biology, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands., Brood-van Zanten MMA; Center for Gynaecological Oncology Amsterdam (CGOA), Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.; Center for Gynaecological Oncology Amsterdam (CGOA), AmsterdamUMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands., Vos MC; Gynaecologic Oncologic Center South Location Elisabeth-TweeSteden Hospital, Hilvarenbeekseweg 60, 5000 LC, Tilburg, The Netherlands., Piek JM; Gynaecologic Oncologic Center South Location Catharina Hospital, Department of Obstetrics and Gynaecology and Catharina Cancer Institute, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands., van Lonkhuijzen LRCW; Center for Gynaecological Oncology Amsterdam (CGOA), AmsterdamUMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands., Apperloo MJA; Department of Obstetrics and Gynaecology, Medical Center Leeuwarden, Henri Dunantweg 2, 8934 AD, Leeuwarden, The Netherlands., Coppus SFPJ; Department of Obstetrics and Gynaecology, Maxima Medical Center, De Run 4600, 5504 DB, Veldhoven, The Netherlands., Prins JB; Department of Medical Psychology, Radboud Institute F Or Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands., Custers JAE; Department of Medical Psychology, Radboud Institute F Or Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands., de Hullu JA; Department of Obstetrics and Gynaecology, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2022 Apr; Vol. 30 (4), pp. 3409-3418. Date of Electronic Publication: 2022 Jan 08.
DOI: 10.1007/s00520-021-06726-4
Abstrakt: Objective: 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 undergoing surgery to prevent ovarian cancer, and identified factors associated with high cancer worry.
Methods: Cancer worry was evaluated as part of the multicentre, prospective TUBA-study (NCT02321228) in which BRCA1/2-PV carriers choose either novel risk-reducing salpingectomy with delayed oophorectomy or standard risk-reducing salpingo-oophorectomy. The Cancer Worry Scale was obtained before and 3 and 12 months after surgery. Cancer worry patterns were analysed using latent class growth analysis and associated factors were identified with regression analysis.
Results: Of all 577 BRCA1/2-PV carriers, 320 (57%) had high (≥ 14) cancer worry pre-surgery, and 54% had lower worry 12 months post-surgery than pre-surgery. Based on patterns over time, BRCA1/2-PV carriers could be classified into three groups: persistently low cancer worry (56%), persistently high cancer worry (6%), and fluctuating, mostly declining, cancer worry (37%). Factors associated with persistently high cancer concerns were age below 35 (BRCA1) or 40 (BRCA2), unemployment, previous breast cancer, lower education and a more recent BRCA1/2-PV diagnosis.
Conclusions: Some degree of cancer worry is considered normal, and most BRCA1/2-PV carriers have declining cancer worry after gynaecological risk-reducing surgery. However, a subset of these BRCA1/2-PV carriers has persisting major cancer concerns up to 1 year after surgery. They should be identified and potentially offered additional support.
Clinical Trial Registration: The TUBA-study is registered at ClinicalTrials.gov since December 11th, 2014. Registration number: NCT02321228.
(© 2021. The Author(s).)
Databáze: MEDLINE
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