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A Psychological Perspective on Factors Predicting Prophylactic Salpingo-Oophorectomy in a Sample of Italian Women from the General Population. Results from a Hypothetical Study in the Context of BRCA Mutations

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Journal of Genetic Counseling

Abstract

The aim of this study was to assess attitudes toward ovarian cancer risk management options for BRCA mutation carriers in healthy Italian women, and to identify predictors of the preference for risk reducing salpingo-oophorectomy (RRSO) over surveillance. One hundred eighty-one women aged 30–45 completed a questionnaire about preferences, knowledge, risk perception, and socio-demographic information. Participants were randomly presented with a pamphlet about BRCA1 or BRCA2 mutation-specific testing, consequences of testing and preventive options for carriers, and they were stratified by having children or not and by age group. Surveillance was the preferred option (64.6%), followed by RRSO (24.3%). Although RRSO is the only effective strategy available to BRCA carriers, most healthy women faced for the first time with this option may not consider it as their preferred choice. Predictors associated with a higher likelihood to prefer surgery over surveillance were: knowing that life expectancy is longer with surgery, perceived comprehension of the consequences of testing, previous knowledge about BRCA testing, anticipated worry about developing cancer, and feelings of risk. Childbearing intentions and the effect of childbearing intentions on choice were associated with a lower preference for surgery. Further research is needed to confirm the role of the factors identified in this study in order to promote informed decision-making about RRSO.

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Notes

  1. These figures were based on estimates recently reported (Mavaddat et al. 2013) rounded to the closest tens. This choice was based on previous work suggesting that: absolute risk reduction information should be provided (e.g., Akl et al. 2011), integers are better remembered and more believable than numbers with decimals (Witteman et al. 2011), and patients better comprehend information with less details, that reduce the cognitive burden of comparing information (Peters et al. 2007).

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Acknowledgements

The authors thank Nadia Ballestrin, Lisa Favaro, and Elisabetta Gogna who collected data as part of their theses. The authors grateful acknowledge statistical insights provided by Lucia Ronconi. No sponsor funded the present study; the only financial supports were a personal funding to LL from the University of Padova (fondi quota ex 60%) that was used to make paper copies of the study material and funding to LV from “Fondi 5 per mille” to IRCCS AOU San Martino – IST, Genoa that was used for the development of study material.

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Authors and Affiliations

  1. Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131, Padova, Italy

    Teresa Gavaruzzi & Lorella Lotto

  2. Department of Humanities, University of Ferrara, Ferrara, Italy

    Alessandra Tasso

  3. Unit of Hereditary Cancer, IRCCS AOU San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

    Marzena Franiuk & Liliana Varesco

  4. Center for Cognitive Neuroscience, University of Padova, Padova, Italy

    Lorella Lotto

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  1. Teresa Gavaruzzi
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  2. Alessandra Tasso
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Correspondence to Teresa Gavaruzzi.

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Teresa Gavaruzzi, Alessandra Tasso, Marzena Franiuk, Liliana Varesco and Lorella Lotto declare that they have no conflict of interest.

Human Studies and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.

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Gavaruzzi, T., Tasso, A., Franiuk, M. et al. A Psychological Perspective on Factors Predicting Prophylactic Salpingo-Oophorectomy in a Sample of Italian Women from the General Population. Results from a Hypothetical Study in the Context of BRCA Mutations. J Genet Counsel 26, 1144–1152 (2017). https://doi.org/10.1007/s10897-017-0093-8

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  • DOI: https://doi.org/10.1007/s10897-017-0093-8

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