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

• Published in: Gynecologic oncology 2012-12, Vol.127 (3), p.556-563
• Main Authors: Brain, Kate E, Lifford, Kate J, Fraser, Lindsay, Rosenthal, Adam N, Rogers, Mark T, Lancastle, Deborah, Phelps, Ceri, Watson, Eila K, Clements, Alison, Menon, Usha
• Format: Article
• Language: English
• Subjects: Adult; Early Detection of Cancer - psychology; Female; Genetic risk; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Obstetrics and Gynecology; Ovarian cancer; Ovarian Neoplasms - genetics; Ovarian Neoplasms - psychology; Psychological outcomes; Risk management; Screening; Time Factors
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2012.08.034

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.