Women’s Intentions to Engage in Risk-Reducing Behaviours after Receiving Personal Ovarian Cancer Risk Information: An Experimental Survey Study

Abstract

Risk stratification using genetic and/or other types of information could identify women at increased ovarian cancer risk. The aim of this study was to examine women’s potential reactions to ovarian cancer risk stratification. A total of 1017 women aged 45–75 years took part in an online experimental survey. Women were randomly assigned to one of three experimental conditions describing hypothetical personal results from ovarian cancer risk stratification, and asked to imagine they had received one of three results: (a) 5% lifetime risk due to single nucleotide polymorphisms (SNPs) and lifestyle factors; (b) 10% lifetime risk due to SNPs and lifestyle factors; (c) 10% lifetime risk due to a single rare mutation in a gene. Results: 83% of women indicated interest in having ovarian cancer risk assessment. After receiving their hypothetical risk estimates, 29% of women stated they would have risk-reducing surgery. Choosing risk-reducing surgery over other behavioural responses was associated with having higher surgery self-efficacy and perceived response-efficacy, but not with perceptions of disease threat, i.e., perceived risk or severity, or with experimental condition. A substantial proportion of women age 45–75 years may be open to the idea of surgery to reduce risk of ovarian cancer, even if their absolute lifetime risk is only increased to as little as 5 or 10%.

Screening and prevention of ovarian cancer

“…RRSO is cost‐effective at 4–5% or more lifetime ovarian cancer risk thresholds 73,88 . This saves seven to ten years of a woman's life and has been found to be acceptable 73,88,89 . This 4–5% lifetime ovarian cancer risk threshold has been supported by a Royal College of Obstetricians and Gynaecologists scientific impact paper 56 and a UK Cancer Genetics Group consensus statement 55 .…”

“…73,88 This saves seven to ten years of a woman's life and has been found to be acceptable. 73,88,89 This 4-5% lifetime ovarian cancer risk threshold has been supported by a Royal College of Obstetricians and Gynaecologists scientific impact paper 56 and a UK Cancer Genetics Group consensus statement. 55 An American group suggested a lower 3-4% lifetime ovarian cancer risk threshold be considered.…”

Gynecologic Cancer Risk and Genetics: Informing an Ideal Model of Gynecologic Cancer Prevention

“…A pilot study of a general population women who self-referred themselves for the study based on leaflets made available at primary care practices, demonstrated feasibility, acceptability, high uptake, and satisfaction with risk assessment approaches along with a reduction in cancer risk perception and worry with time [ 23 ]. General population surveys have shown that women are keen to know their personalized cancer risk and would undergo surgical prevention if found to be at increased risk [ 24 , 25 ].…”

Special Issue “Gynaecological Cancers Risk: Breast Cancer, Ovarian Cancer and Endometrial Cancer”

“…This sets the stage for larger implementation studies to follow. In a randomised experimental survey of general population women, Gallagher et al [ 3 ] show that women are willing to undergo risk reducing surgery to reduce their ovarian cancer risk at a range of risk levels and that uptake rates are similar for 5–10% and >10% life time ovarian cancer risks. For the first time, Manchanda et al [ 4 ] demonstrate the cost-effectiveness of population-based BRCA testing across multiple high income and upper middle income countries health systems (USA, UK, Netherlands, China and Brazil).…”