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Psychological outcomes of familial ovarian cancer screening: No evidence of long-term harm

Brain, Katherine Emma, Lifford, Kate Joanna, Fraser, Lindsay, Rosenthal, Adam N., Rogers, Mark, Lancastle, Deborah, Phelps, Ceri, Watson, Eila K., Clements, Alison and Menon, Usha 2012. Psychological outcomes of familial ovarian cancer screening: No evidence of long-term harm. Gynecologic Oncology 127 (3) , pp. 556-563. 10.1016/j.ygyno.2012.08.034

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Abstract

Objectives Ovarian cancer screening for women at increased genetic risk in the UK involves 4-monthly CA125 tests and annual ultrasound, with further tests prompted by an abnormal result. The study evaluated the longer-term psychological and behavioural effects of frequent ovarian screening. Methods Women completed T1 questionnaires before their first routine 4-monthly CA125 test, and T2 follow-up questionnaires one week after their result. Women with abnormal results completed a further questionnaire one week after return to routine screening (T3 primary end-point). T4 questionnaires were sent at nine months. Measures included cancer distress, general anxiety/depression, reassurance, and withdrawal from screening. Results A total 1999 (62%) of 3224 women completed T1 questionnaires. T2 questionnaires were completed by 1384/1609 participants (86%): 1217 (89%) with normal results and 167/242 (69%) with abnormal results. T3 questionnaires were completed by 141/163 (87%) women, with 912/1173 (78%) completing T4 questionnaires. Analysis of covariance indicated that, compared to women with normal results, women with abnormal results reported moderate cancer distress (F = 27.47, p ≤ .001, η2 = 0.02) one week after their abnormal result and were significantly more likely to withdraw from screening (OR = 4.38, p ≤ .001). These effects were not apparent at T3 or T4. The effect of screening result on general anxiety/depression or overall reassurance was not significant. Conclusions Women participating in frequent ovarian screening who are recalled for an abnormal result may experience transient cancer-specific distress, which may prompt reconsideration of risk management options. Health professionals and policy makers may be reassured that frequent familial ovarian screening does not cause sustained psychological harm.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RM Therapeutics. Pharmacology
Uncontrolled Keywords: Ovarian cancer ; Screening ; Genetic risk ; Psychological outcomes ; Risk management
Publisher: Elsevier
ISSN: 0090-8258
Last Modified: 12 Jan 2018 19:25
URI: http://orca-mwe.cf.ac.uk/id/eprint/37483

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