Public perception of risk-reducing salpingectomy for preventing ovarian cancer

Ovarian cancer (OC) is the most lethal gynecologic malignancy and in-time diagnosis is limited because of the absence of effective biomarkers. Germline BRCA1/2 genetic alterations are risk factors for hereditary OC; risk-reducing salpingo-oophorectomy (RRSO) is pursued for disease prevention. However, not all healthy carriers develop the disease. Therefore, identifying predictive markers in the BRCA1/2 carrier population could help improve the identification of candidates for preventive RRSO. In this study, plasma samples from 20 OC patients (10 patients with BRCA1/2 wild type (wt) and 10 with the BRCA1/2 variant (var)) and 20 normal subjects (10 subjects with BRCA1/2wt and 10 with BRCA1/2var) were analyzed for potential biomarkers of hereditary OC. We applied a bottom-up proteomics approach, using nano-flow LC-MS to analyze depleted plasma proteome quantitatively, and potential plasma protein markers specific to the BRCA1/2 variant were identified from a comparative statistical analysis of the four groups. We obtained 1505 protein candidates from the 40 subjects, and SPARC and THBS1 were verified by enzyme-linked immunosorbent assay. Plasma SPARC and THBS1 concentrations in healthy BRCA1/2 carriers were found to be lower than in OC patients with BRCA1/2var. If plasma SPARC concentrations increase over 337.35 ng/ml or plasma THBS1 concentrations increase over 65.28 mg/ml in a healthy BRCA1/2 carrier, oophorectomy may be suggested.

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A competing risks model with binary time varying covariates for estimation of breast cancer risks in BRCA1 families

Statistical Methods in Medical Research ◽

10.1177/09622802211008945 ◽

2021 ◽

pp. 096228022110089

Author(s):

Yun-Hee Choi ◽

Hae Jung ◽

Saundra Buys ◽

Mary Daly ◽

Esther M John ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Competing Risks ◽

Brca1 Mutation ◽

Prophylactic Surgery ◽

Time Varying ◽

Cancer Risks ◽

Competing Risks Model ◽

Time Varying Covariates ◽

Risk Reducing

Mammographic screening and prophylactic surgery such as risk-reducing salpingo oophorectomy can potentially reduce breast cancer risks among mutation carriers of BRCA families. The evaluation of these interventions is usually complicated by the fact that their effects on breast cancer may change over time and by the presence of competing risks. We introduce a correlated competing risks model to model breast and ovarian cancer risks within BRCA1 families that accounts for time-varying covariates. Different parametric forms for the effects of time-varying covariates are proposed for more flexibility and a correlated gamma frailty model is specified to account for the correlated competing events.We also introduce a new ascertainment correction approach that accounts for the selection of families through probands affected with either breast or ovarian cancer, or unaffected. Our simulation studies demonstrate the good performances of our proposed approach in terms of bias and precision of the estimators of model parameters and cause-specific penetrances over different levels of familial correlations. We applied our new approach to 498 BRCA1 mutation carrier families recruited through the Breast Cancer Family Registry. Our results demonstrate the importance of the functional form of the time-varying covariate effect when assessing the role of risk-reducing salpingo oophorectomy on breast cancer. In particular, under the best fitting time-varying covariate model, the overall effect of risk-reducing salpingo oophorectomy on breast cancer risk was statistically significant in women with BRCA1 mutation.

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230 Referral patterns and uptake of risk reducing surgery for non-brca genes associated with increased risk of epithelial ovarian cancer

10.1136/ijgc-2019-igcs.230 ◽

2019 ◽

Author(s):

S Lee ◽

B Bhuptani ◽

S Turecamo ◽

D Gerber ◽

J Smith ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Referral Patterns ◽

Brca Genes ◽

Increased Risk ◽

Risk Reducing

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Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer

PLoS ONE ◽

10.1371/journal.pone.0169673 ◽

2017 ◽

Vol 12 (1) ◽

pp. e0169673 ◽

Cited By ~ 5

Author(s):

Ingrid E. Fakkert ◽

Eveline van der Veer ◽

Elske Marije Abma ◽

Joop D. Lefrandt ◽

Bruce H. R. Wolffenbuttel ◽

...

Keyword(s):

Ovarian Cancer ◽

Bone Turnover ◽

Bone Turnover Markers ◽

Breast And Ovarian Cancer ◽

Increased Risk ◽

Turnover Markers ◽

Risk Reducing

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Clinical and pathological outcomes of risk-reducing salpingo-oophorectomy for Japanese women with hereditary breast and ovarian cancer

International Journal of Clinical Oncology ◽

10.1007/s10147-021-02020-9 ◽

2021 ◽

Author(s):

Hidetaka Nomura ◽

Ai Ikki ◽

Atsushi Fusegi ◽

Makiko Omi ◽

Yoichi Aoki ◽

...

Keyword(s):

Ovarian Cancer ◽

Japanese Women ◽

Breast And Ovarian Cancer ◽

Risk Reducing

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Predictors of risk-reducing surgery intentions following genetic counseling for hereditary breast and ovarian cancer

Translational Behavioral Medicine ◽

10.1093/tbm/iby101 ◽

2018 ◽

Vol 10 (2) ◽

pp. 337-346 ◽

Cited By ~ 3

Author(s):

Mary Kathleen Ladd ◽

Beth N Peshkin ◽

Leigha Senter ◽

Shari Baldinger ◽

Claudine Isaacs ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Genetic Counseling ◽

Cancer Risk ◽

Prophylactic Surgery ◽

Ovarian Cancer Risk ◽

Breast And Ovarian Cancer ◽

Affective Factors ◽

Risk Reducing

Abstract Risk-reducing mastectomy (RRM) and salpingo-oophorectomy (RRSO) are increasingly used to reduce breast and ovarian cancer risk following BRCA1/BRCA2 testing. However, little is known about how genetic counseling influences decisions about these surgeries. Although previous studies have examined intentions prior to counseling, few have examined RRM and RRSO intentions in the critical window between genetic counseling and test result disclosure. Previous research has indicated that intentions at this time point predict subsequent uptake of surgery, suggesting that much decision-making has taken place prior to result disclosure. This period may be a critical time to better understand the drivers of prophylactic surgery intentions. The aim of this study was to examine predictors of RRM and RRSO intentions. We hypothesized that variables from the Health Belief Model would predict intentions, and we also examined the role of affective factors. Participants were 187 women, age 21–75, who received genetic counseling for hereditary breast and ovarian cancer. We utilized multiple logistic regression to identify independent predictors of intentions. 49.2% and 61.3% of participants reported intentions for RRM and RRSO, respectively. Variables associated with RRM intentions include: newly diagnosed with breast cancer (OR = 3.63, 95% CI = 1.20–11.04), perceived breast cancer risk (OR = 1.46, 95% CI = 1.17–1.81), perceived pros (OR = 1.79, 95% CI = 1.38–2.32) and cons of RRM (OR = 0.81, 95% CI = 0.65–0.996), and decision conflict (OR = 0.80, 95% CI = 0.66–0.98). Variables associated with RRSO intentions include: proband status (OR = 0.28, 95% CI = 0.09–0.89), perceived pros (OR = 1.35, 95% CI = 1.11–1.63) and cons of RRSO (OR = 0.72, 95% CI = 0.59–0.89), and ambiguity aversion (OR = 0.79, 95% CI = 0.65–0.95). These data provide support for the role of genetic counseling in fostering informed decisions about risk management, and suggest that the role of uncertainty should be explored further.

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The public perception of risk

Proceedings of the Royal Society of Edinburgh Section B Biological Sciences ◽

10.1017/s026972700000960x ◽

1987 ◽

Vol 92 (1-2) ◽

pp. 155-157

Author(s):

J. Lenihan

Keyword(s):

Public Perception ◽

Quantitative Assessment ◽

Political Control ◽

Perception Of Risk ◽

Accident Rate ◽

The Public

SynopsisIf technology aims to direct natural forces for the use and convenience of man, the inconvenience or worse arising from the concomitant hazards requires attention. The quantitative assessment of risk practised by the actuary and engineer differs substantially from the public perception of the same risks. In several longestablished activities there is a remarkably stable, and presumably socially tolerated, accident rate. In newer and more extensively hazardous activities political control, social toleration and public perception of risk interdepend in ways which require further exploration.

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