Korean J Women Health Nurs.  2020 Dec;26(4):285-299. 10.4069/kjwhn.2020.11.19.

Factors associated with the decision to undergo risk-reducing salpingo-oophorectomy among women at high risk for hereditary breast and ovarian cancer: a systematic review

Affiliations
  • 1Graduate School, Yonsei University, Seoul, Korea
  • 2National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
  • 3Mo-Im Kim Nursing Research Institute and College of Nursing, Yonsei University, Seoul, Korea

Abstract

This systematic review aims to identify factors associated with risk-reducing salpingo-oophorectomy (RRSO), including the uptake rate and decision timing, among women at high risk for hereditary breast and ovarian cancer (HBOC). We found 4,935 relevant studies using MEDLINE, Embase, CINAHL, and PsycINFO on July 6, 2020. Two authors screened the articles and extracted data. Twenty-four studies met the inclusion criteria. Quality assessment of articles was conducted using the Risk of Bias for Nonrandomized Studies tool. Five types of factors were identified (demographic factors, clinical factors, family history of cancer, psychological factors, and objective cancer risk). The specific significant factors were older age, having child(ren), being a BRCA1/2 carrier, mastectomy history, perceived risk for ovarian cancer, and perceived advantages of RRSO, whereas objective cancer risk was not significant. The uptake rate of RRSO was 23.4% to 87.2% (mean, 45.2%) among high-risk women for HBOC. The mean time to decide whether to undergo RRSO after BRCA testing was 4 to 34 months. RRSO decisions are affected by demographic, clinical, and psychological factors, rather than objective cancer risk. Nonetheless, women seeking RRSO should be offered information about objective cancer risk. Even though decision-making for RRSO is a complex and multifaceted process, the psychosocial factors that may influence decisions have not been comprehensively examined, including family attitudes toward RRSO, cultural norms, social values, and health care providers’ attitudes.

Keyword

Hereditary breast and ovarian cancer syndrome; Salpingo-oophorectomy; Decision making

Figure

  • Figure 1. Flow diagram of study selection.

  • Figure 2. Risk-of-bias graph. (A) Risk of bias summary. (B) Risk of bias for selected studies


Cited by  1 articles

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