J Gynecol Oncol.
2024 May;35(3):e70. 10.3802/jgo.2024.35.e70.
Hormone replacement therapy in gynecological cancer survivors and BRCA mutation carriers: a MITO group survey
- Palaia I
1 - Caruso G1
- Donato VD1
- Turetta C1
- Savarese A2
- Perniola G1
- Gallo R1
- Giannini A1
- Salutari V3
- Bogani G1
- Tomao F1
- Giannarelli D4
- Gentile G1
- Musella A1
- Muzii L1
- Pignata S5
- obotMg
- Affiliations
-
- 1Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
- 2Department of Oncology, Regina Elena National Cancer Institute, Rome, Italy
- 3Division of Gynecologic Oncology, Department of Women and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica, Rome, Italy
- 4Biostatistic Unit, Regina Elena National Cancer Institute, Rome, Italy
- 5Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
- KMID: 2564902
- DOI: http://doi.org/10.3802/jgo.2024.35.e70
Abstract
Objective
Early iatrogenic menopause in gynecological cancer survivors and BRCA mutation (BRCAm) carriers undergoing risk-reducing salpingo-oophorectomy (RRSO) is a major health concern. Hormone replacement therapy (HRT) is the most effective remedy, but remains underused in clinical practice. The Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) group promoted a national survey to investigate the knowledge and attitudes of healthcare professionals regarding the prescription of HRT.
Methods
The survey consisted of a self-administered, multiple-choice 45-item questionnaire, available online to all MITO members for 2 months starting from January 2022.
Results
A total of 61 participants completed the questionnaire (47 out of 180 MITO centers; compliance: 26.1%). Most respondents were female (73.8%), younger than 50 years (65.6%), and gynecologic oncologists (55.7%), working in public general hospitals (49.2%). An 84.4% of specialists actively discuss HRT with patients and 51.0% of patients ask the specialist for an opinion on HRT. The rate of specialists globally in favor of prescribing HRT was 22.9% for ovarian cancer, 49.1% for cervical cancer, and 8.2% for endometrial cancer patients. Most respondents (70.5%) believe HRT is safe for BRCA-mutated patients after RRSO. Nearly 70% of physicians prescribe systemic HRT, while 23.8% prefer local HRT. Most specialists recommend HRT for as long as there is a benefit and generally for up to 5 years.
Conclusion
Real-world data suggest that many healthcare professionals still do not easily prescribe HRT for gynecological cancer survivors and BRCA mutation carriers after RRSO. Further efforts are required to implement the use of HRT in clinical practice and to support both clinicians in recommending HRT and patients in accepting it.
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