Psychological Aspects of Hereditary and Non-hereditary Ovarian Cancer

  • Kate Absolom
  • Elena Takeuchi
  • Geoff Hall
  • Galina Velikova


Ovarian cancer is typically an aggressive disease, often diagnosed at advanced stages. For many patients treatment regimens are intensive, including both surgery and chemotherapy with a high risk of recurrence in subsequent months or years. Understandably the serious nature of ovarian malignancies and their poor prognosis have led researchers to consider the psychological consequences of the disease. In addition, with around 5–10 % of these cancers being hereditary, a number of questions are raised about how patients and family members understand and cope with decisions surrounding screening and the discovery of genetic predispositions.

To date a variety of quantitative and qualitative studies have assessed the psychological implications of ovarian cancer. In this chapter the findings of this research are discussed. Although there are a number of limitations to the studies conducted, including a paucity of longitudinal research, evidence exists for associations between increased psychological distress and younger age at diagnosis, advanced disease, poor perceived social support and worse physical functioning. The positive impact of the cancer experience has also been documented, with patients reporting changes to their priorities and a greater appreciation for life. Research on the impact of genetic testing for hereditary ovarian cancer indicates that heightened levels of distress are experienced in the period surrounding test results though these frequently decrease over time. Qualitative investigations highlight the complexity of communication and decision making in families where members are at risk of inherited ovarian cancer.

National guidelines for the clinical management of ovarian cancer include recommendations for psychosocial care. Although these outline how patients should be supported with adequate information provision and access to psychological services, the extent to which guidance is effectively translated into routine care is not clear. Ideally more systematic strategies for detecting and managing psychological distress across the disease trajectory are needed to ensure patients obtain appropriate and timely support from specialist services.


Ovarian Cancer Psychological Distress National Cancer Comprehensive Network National Cancer Comprehensive Network Ovarian Cancer Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Distress Management Version 2.2013. Accessed 9 Aug 2013
  2. 2.
    Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10(1):19–28.CrossRefPubMedGoogle Scholar
  3. 3.
    Fann JR, Thomas-Rich AM, Katon WJ, et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry. 2008;30(2):112–26.CrossRefPubMedGoogle Scholar
  4. 4.
    Watson M, Haviland JS, Greer S, Davidson J, Bliss JM. Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet. 1999;354(9187):1331–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Carlson LE, Bultz BD. Benefits of psychosocial oncology care: improved quality of life and medical cost offset. Health Qual Life Outcomes. 2003;1:8.CrossRefPubMedGoogle Scholar
  6. 6.
    Simpson JS, Carlson LE, Trew ME. Effect of group therapy for breast cancer on healthcare utilization. Cancer Pract. 2001;9(1):19–26.CrossRefPubMedGoogle Scholar
  7. 7.
    Cancer Research UK. Ovarian cancer survival statistics. Accessed 01 Dec 2011.
  8. 8.
    Hennessy BT, Coleman RL, Markman M. Ovarian cancer. Lancet. 2009;374(9698):1371–82.CrossRefPubMedGoogle Scholar
  9. 9.
    Casey C, Chen LM, Rabow M. Symptom management in gynecologic malignancies. Expert Rev Anticancer Ther. 2011;11(7):1077–89.CrossRefPubMedGoogle Scholar
  10. 10.
    Kayl AE, Meyers CA. Side-effects of chemotherapy and quality of life in ovarian and breast cancer patients. Curr Opin Obstet Gynecol. 2006;18(1):24–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Portenoy RK, Kornblith AB, Wong G, et al. Pain in ovarian-cancer patients - prevalence, characteristics, and associated symptoms. Cancer. 1994;74(3):907–15.CrossRefPubMedGoogle Scholar
  12. 12.
    Price MA, Zachariae R, Butow PN, et al. Prevalence and predictors of insomnia in women with invasive ovarian cancer: anxiety a major factor. Eur J Cancer. 2009;45(18):3262–70.CrossRefPubMedGoogle Scholar
  13. 13.
    Sun CC, Bodurka DC, Donato ML, et al. Patient preferences regarding side effects of chemotherapy for ovarian cancer: do they change over time? Gynecol Oncol. 2002;87(1):118–28.CrossRefPubMedGoogle Scholar
  14. 14.
    National Cancer Institute. PDQ® Cancer Information Summary Genetics of Breast and Ovarian Cancer (PDQ®) - Health Professional. Accessed 01 Dec 2011.
  15. 15.
    Vasen HFA, Stormorken A, Menko FH, et al. MSH2 mutation carriers are at higher risk of cancer than MLH1 mutation carriers: a study of hereditary nonpolyposis colorectal cancer families. J Clin Oncol. 2001;19(20):4074–80.PubMedGoogle Scholar
  16. 16.
    Manchanda R, Menon U, Michaelson-Cohen R, Beller U, Jacobs I. Hereditary non-polyposis colorectal cancer or Lynch syndrome: the gynaecological perspective. Curr Opin Obstet Gynecol. 2009;21(1):31–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Arden-Close E, Gidron Y, Moss-Morris R. Psychological distress and its correlates in ovarian cancer: a systematic review. Psychooncology. 2008;17(11):1061–72.CrossRefPubMedGoogle Scholar
  18. 18.
    Hipkins J, Whitworth M, Tarrier N, Jayson G. Social support, anxiety and depression after chemotherapy for ovarian cancer: a prospective study. Br J Health Psychol. 2004;9(Pt 4):569–81.CrossRefPubMedGoogle Scholar
  19. 19.
    Kornblith AB, Thaler HT, Wong G, et al. Quality of life of women with ovarian cancer. Gynecol Oncol. 1995;59(2):231–42.CrossRefPubMedGoogle Scholar
  20. 20.
    Bodurka-Bevers D, Basen-Engquist K, Carmack CL, et al. Depression, anxiety, and quality of life in patients with epithelial ovarian cancer. Gynecol Oncol. 2000;78(3 Pt 1):302–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Goncalves V, Jayson G, Tarrier N. A longitudinal investigation of psychological morbidity in patients with ovarian cancer. Br J Cancer. 2008;99(11):1794–801.CrossRefPubMedGoogle Scholar
  22. 22.
    Hodgkinson K, Butow P, Fuchs A, et al. Long-term survival from gynecologic cancer: psychosocial outcomes, supportive care needs and positive outcomes. Gynecol Oncol. 2007;104(2):381–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Norton TR, Manne SL, Rubin S, et al. Prevalence and predictors of psychological distress among women with ovarian cancer. J Clin Oncol. 2004;22(5):919–26.CrossRefPubMedGoogle Scholar
  24. 24.
    Norton TR, Manne SL, Rubin S, et al. Ovarian cancer patients’ psychological distress: the role of physical impairment, perceived unsupportive family and friend behaviors, perceived control, and self-esteem. Health Psychol. 2005;24(2):143–52.CrossRefPubMedGoogle Scholar
  25. 25.
    Wenzel LB, Donnelly JP, Fowler JM, et al. Resilience, reflection, and residual stress in ovarian cancer survivorship: a gynecologic oncology group study. Psychooncology. 2002;11(2):142–53.CrossRefPubMedGoogle Scholar
  26. 26.
    Petersen RW, Graham G, Quinlivan JA. Psychologic changes after a gynecologic cancer. J Obstet Gynaecol Res. 2005;31(2):152–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Boscaglia N, Clarke DM, Jobling TW, Quinn MA. The contribution of spirituality and spiritual coping to anxiety and depression in women with a recent diagnosis of gynecological cancer. Int J Gynecol Cancer. 2005;15(5):755–61.CrossRefPubMedGoogle Scholar
  28. 28.
    Molassiotis A, Chan CW, Yam BM, Chan SJ. Quality of life in Chinese women with gynaecological cancers. Support Care Cancer. 2000;8(5):414–22.CrossRefPubMedGoogle Scholar
  29. 29.
    Parker PA, Kudelka A, Basen-Engquist K, Kavanagh J, de Moor J, Cohen L. The associations between knowledge, CA125 preoccupation, and distress in women with epithelial ovarian cancer. Gynecol Oncol. 2006;100(3):495–500.CrossRefPubMedGoogle Scholar
  30. 30.
    Ponto JA, Ellington L, Mellon S, Beck SL. Predictors of adjustment and growth in women with recurrent ovarian cancer. Oncol Nurs Forum. 2010;37(3):357–64.CrossRefPubMedGoogle Scholar
  31. 31.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: APA; 1994. DSM–IV.Google Scholar
  32. 32.
    Goncalves V, Jayson G, Tarrier N. A longitudinal investigation of posttraumatic stress disorder in patients with ovarian cancer. J Psychosom Res. 2011;70(5):422–31.CrossRefPubMedGoogle Scholar
  33. 33.
    Matulonis UA, Kornblith A, Lee H, et al. Long-term adjustment of early-stage ovarian cancer survivors. Int J Gynecol Cancer. 2008;18(6):1183–93.CrossRefPubMedGoogle Scholar
  34. 34.
    Mirabeau-Beale KL, Kornblith AB, Penson RT, et al. Comparison of the quality of life of early and advanced stage ovarian cancer survivors. Gynecol Oncol. 2009;114(2):353–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Posluszny DM, Edwards RP, Dew MA, Baum A. Perceived threat and PTSD symptoms in women undergoing surgery for gynecologic cancer or benign conditions. Psychooncology. 2011;20(7):783–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Bisseling KCHM, Kondalsamy-Chennakesavan S, Bekkers RLM, Janda M, Obermair A. Depression, anxiety and body image after treatment for invasive stage one epithelial ovarian cancer. Aust N Z J Obstet Gynaecol. 2009;49(6):660–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Miller RE, Rustin GJ. How to follow-up patients with epithelial ovarian cancer. Curr Opin Oncol. 2010;22(5):498–502.CrossRefPubMedGoogle Scholar
  38. 38.
    Jordens CF, Morrell B, Harnett P, Hobbs K, Mason C, Kerridge IH. Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer. Soc Sci Med. 2010;71(9):1548–56.CrossRefPubMedGoogle Scholar
  39. 39.
    Karam AK, Karlan BY. Ovarian cancer: the duplicity of CA125 measurement. Nat Rev Clin Oncol. 2010;7(6):335–9.CrossRefPubMedGoogle Scholar
  40. 40.
    Oskay-Oezcelik G, du Bois A, Fasching PA, et al. What do patients think about CA-125 monitoring in the follow-up? Results from a multicenter trial in 1,060 patients with ovarian cancer. J Clin Oncol. 2009;27(15s):5522.Google Scholar
  41. 41.
    Markman M, Peterson J, Belland A, Burg K. CA-125 monitoring in ovarian cancer: patient survey responses to the results of the MRC/EORTC CA-125 surveillance trial. Oncology. 2010;78:1–2.CrossRefPubMedGoogle Scholar
  42. 42.
    Kew F, Galaal K, Bryant A, Naik R. Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment. Cochrane Database Syst Rev. 2011;(6):CD006119.Google Scholar
  43. 43.
    Power J, Brown L, Ritvo P. A qualitative study examining psychosocial distress, coping, and social support across the stages and phases of epithelial ovarian cancer. Health Care Women Int. 2008;29(4):366–83.CrossRefPubMedGoogle Scholar
  44. 44.
    Australian Ovarian Cancer Study. Accessed 01 Dec 2011.
  45. 45.
    Price MA, Butow PN, Costa DSJ, et al. Prevalence and predictors of anxiety and depression in women with invasive ovarian cancer and their caregivers. Med J Aust. 2010;193(5):S52–7.PubMedGoogle Scholar
  46. 46.
    Mahdi H, Swensen RE, Munkarah AR, et al. Suicide in women with gynecologic cancer. Gynecol Oncol. 2011;122(2):344–9.CrossRefPubMedGoogle Scholar
  47. 47.
    Jansen L, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V. Benefit finding and post-traumatic growth in long-term colorectal cancer survivors: prevalence, determinants, and associations with quality of life. Br J Cancer. 2011;105(8):1158–65.CrossRefPubMedGoogle Scholar
  48. 48.
    Mols F, Vingerhoets AJJM, Coebergh JWW, van de Poll-Franse LV. Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors. Psychol Health. 2009;24(5):583–95.CrossRefPubMedGoogle Scholar
  49. 49.
    Stewart DE, Wong F, Duff S, Melancon CH, Cheung AM. “What doesn’t kill you makes you stronger”: an ovarian cancer survivor survey. Gynecol Oncol. 2001;83(3):537–42.CrossRefPubMedGoogle Scholar
  50. 50.
    Ponto JA, Barton D. Husbands ‘perspective of living with wives’ ovarian cancer. Psychooncology. 2008;17(12):1225–31.CrossRefPubMedGoogle Scholar
  51. 51.
    Lutgendorf SK, Anderson B, Ullrich P, et al. Quality of life and mood in women with gynecologic cancer: a one year prospective study. Cancer. 2002;94(1):131–40.CrossRefPubMedGoogle Scholar
  52. 52.
    Carey M, Noble N, Sanson-Fisher R, Mackenzie L. Identifying psychological morbidity among people with cancer using the Hospital Anxiety and Depression Scale: time to revisit first principles? Psychooncology. 2011;21(3):229–38. doi: 10.1002/pon.2057. Early view (online version).CrossRefPubMedGoogle Scholar
  53. 53.
    Ziegler L, Hill K, Neilly L, et al. A systematic review of self-report measure performance at key stages of the cancer illness trajectory. J Pain Symptom Manage. 2011;41(3):619–36.CrossRefPubMedGoogle Scholar
  54. 54.
    Armes J, Crowe M, Colbourne L, et al. Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol. 2009;27(36):6172–9.CrossRefPubMedGoogle Scholar
  55. 55.
    Beesley V, Eakin E, Steginga S, Aitken J, Dunn J, Battistutta D. Unmet needs of gynaecological cancer survivors: implications for developing community support services. Psychooncology. 2008;17(4):392–400.CrossRefPubMedGoogle Scholar
  56. 56.
    Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ. What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer. 2009;17(8):1117–28.CrossRefPubMedGoogle Scholar
  57. 57.
    Merckaert I, Libert Y, Messin S, Milani M, Slachmuylder JL, Razavi D. Cancer patients’ desire for psychological support: prevalence and implications for screening patients’ psychological needs. Psychooncology. 2010;19(2):141–9.CrossRefPubMedGoogle Scholar
  58. 58.
    National Institute of Health & Clinical Excellence. Improving supportive and palliative care for adults with cancer: the manual. London: National Institute for Clinical Excellence; 2004.Google Scholar
  59. 59.
    National Breast Cancer Centre and the National Cancer Control Initiative. Clinical practice guidelines for the psychosocial care of adults with cancer. Camperdown: National Breast Cancer Centre; 2003.Google Scholar
  60. 60.
    National Cancer Action Team. Connected: National communication skills training. 2011;
  61. 61.
    Sharpe M, Strong V, Allen K, et al. Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs. Br J Cancer. 2004;90(2):314–20.CrossRefPubMedGoogle Scholar
  62. 62.
    Passik SD, Dugan W, McDonald MV, Rosenfeld B, Theobald DE, Edgerton S. Oncologists’ recognition of depression in their patients with cancer. J Clin Oncol. 1998;16(4):1594–600.PubMedGoogle Scholar
  63. 63.
    Fallowfield L, Ratcliffe D, Jenkins V, Saul J. Psychiatric morbidity and its recognition by doctors in patients with cancer. Br J Cancer. 2001;84(8):1011–5.CrossRefPubMedGoogle Scholar
  64. 64.
    McLachlan SA, Allenby A, Matthews J, et al. Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol. 2001;19(21):4117–25.PubMedGoogle Scholar
  65. 65.
    Velikova G, Booth L, Smith AB, et al. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol. 2004;22(4):714–24.CrossRefPubMedGoogle Scholar
  66. 66.
    Strong V, Waters R, Hibberd C, et al. Management of depression for people with cancer (SMaRT oncology 1): a randomised trial. Lancet. 2008;372(9632):40–8.CrossRefPubMedGoogle Scholar
  67. 67.
    Detmar SB, Muller MJ, Schornagel JH, Wever LDV, Aaronson NK. Health-related quality-of-life assessments and patient-physician communication - a randomized controlled trial. JAMA. 2002;288(23):3027–34.CrossRefPubMedGoogle Scholar
  68. 68.
    Jacobsen PB, Ransom S. Implementation of NCCN distress management guidelines by member institutions. J Natl Compr Canc Netw. 2007;5(1):99–103.PubMedGoogle Scholar
  69. 69.
    Mitchell AJ, Kaar S, Coggan C, Herdman J. Acceptability of common screening methods used to detect distress and related mood disorders-preferences of cancer specialists and non-specialists. Psychooncology. 2008;17(3):226–36.CrossRefPubMedGoogle Scholar
  70. 70.
    Absolom K, Holch P, Pini S, et al. The detection and management of emotional distress in cancer patients: the views of health care professionals. Psychooncology. 2011;20(6):601–8.CrossRefPubMedGoogle Scholar
  71. 71.
    Gessler S, Low J, Daniells E, et al. Screening for distress in cancer patients: is the distress thermometer a valid measure in the UK and does it measure change over time? A prospective validation study. Psychooncology. 2008;17(6):538–47.CrossRefPubMedGoogle Scholar
  72. 72.
    Johnson RL, Gold MA, Wyche KF. Distress in women with gynecologic cancer. Psychooncology. 2010;19(6):665–8.CrossRefPubMedGoogle Scholar
  73. 73.
    McCorkle R, Dowd M, Ercolano E, et al. Effects of a nursing intervention on quality of life outcomes in post-surgical women with gynecological cancers. Psychooncology. 2009;18(1):62–70.CrossRefPubMedGoogle Scholar
  74. 74.
    Henry M, Cohen SR, Lee V, et al. The Meaning-Making intervention (MMi) appears to increase meaning in life in advanced ovarian cancer: a randomized controlled pilot study. Psychooncology. 2010;19(12):1340–7.CrossRefPubMedGoogle Scholar
  75. 75.
    Hersch J, Juraskova I, Price M, Mullan B. Psychosocial interventions and quality of life in gynaecological cancer patients: a systematic review. Psychooncology. 2009;18(8):795–810.CrossRefPubMedGoogle Scholar
  76. 76.
    McAllister M, Davies L, Payne K, Nicholls S, Donnai D, MacLeod R. The emotional effects of genetic diseases: implications for clinical genetics. Am J Med Genet A. 2007;143A(22):2651–61.CrossRefPubMedGoogle Scholar
  77. 77.
    Hopwood P. Psychosocial aspects of risk communication and mutation testing in familial breast-ovarian cancer. Curr Opin Oncol. 2005;17(4):340–4.CrossRefPubMedGoogle Scholar
  78. 78.
    Vadaparampil ST, Wey JP, Kinney AY. Psychosocial aspects of genetic counseling and testing. Semin Oncol Nurs. 2004;20(3):186–95.CrossRefPubMedGoogle Scholar
  79. 79.
    Cull A, Fry A, Rush R, Steel CM. Cancer risk perceptions and distress among women attending a familial ovarian cancer clinic. Br J Cancer. 2001;84(5):594–9.CrossRefPubMedGoogle Scholar
  80. 80.
    Erlick Robinson G, Rosen BP, Bradley LN, et al. Psychological impact of screening for familial ovarian cancer: reactions to initial assessment. Gynecol Oncol. 1997;65(2):197–205.CrossRefPubMedGoogle Scholar
  81. 81.
    Wardle FJ, Collins W, Pernet AL, Whitehead MI, Bourne TH, Campbell S. Psychological impact of screening for familial ovarian cancer. J Natl Cancer Inst. 1993;85(8):653–7.CrossRefPubMedGoogle Scholar
  82. 82.
    Schwartz MD, Peshkin BN, Hughes C, Main D, Isaacs C, Lerman C. Impact of BRCA1/BRCA2 mutation testing on psychologic distress in a clinic-based sample. J Clin Oncol. 2002;20(2):514–20.CrossRefPubMedGoogle Scholar
  83. 83.
    Watson M, Foster C, Eeles R, et al. Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort. Br J Cancer. 2004;91(10):1787–94.CrossRefPubMedGoogle Scholar
  84. 84.
    Wood ME, Mullineaux L, Rahm AK, Fairclough D, Wenzel L. Impact of BRCA1 testing on women with cancer: a pilot study. Genet Test. 2000;4(3):265–72.CrossRefPubMedGoogle Scholar
  85. 85.
    Hamilton JG, Lobel M, Moyer A. Emotional distress following genetic testing for hereditary breast and ovarian cancer: a meta-analytic review. Health Psychol. 2009;28(4):510–8.CrossRefPubMedGoogle Scholar
  86. 86.
    Baum A, Friedman AL, Zakowski SG. Stress and genetic testing for disease risk. Health Psychol. 1997;16(1):8–19.CrossRefPubMedGoogle Scholar
  87. 87.
    Hallowell N, Foster C, Eeles R, Ardern-Jones A, Watson M. Accommodating risk: responses to BRCA1/2 genetic testing of women who have had cancer. Soc Sci Med. 2004;59(3):553–65.CrossRefPubMedGoogle Scholar
  88. 88.
    Germino BB, Fife BL, Funk SG. Cancer and the partner relationship: what is its meaning? Semin Oncol Nurs. 1995;11(1):43–50.CrossRefPubMedGoogle Scholar
  89. 89.
    Pistrang N, Barker C. The partner relationship in psychological response to breast-cancer. Soc Sci Med. 1995;40(6):789–97.CrossRefPubMedGoogle Scholar
  90. 90.
    van Oostrom I, Meijers-Heijboer H, Lodder LN, et al. Long-term psychological impact of carrying a BRCA1/2 mutation and prophylactic surgery: a 5-year follow-up study. J Clin Oncol. 2003;21(20):3867–74.CrossRefPubMedGoogle Scholar
  91. 91.
    Mellon S, Berry-Bobovski L, Gold R, Levin N, Tainsky MA. Communication and decision-making about seeking inherited cancer risk information: findings from female survivor-relative focus groups. Psychooncology. 2006;15(3):193–208.CrossRefPubMedGoogle Scholar
  92. 92.
    Dancyger C, Smith JA, Jacobs C, Wallace M, Michie S. Comparing family members’ motivations and attitudes towards genetic testing for hereditary breast and ovarian cancer: a qualitative analysis. Eur J Hum Genet. 2010;18(12):1289–95.CrossRefPubMedGoogle Scholar
  93. 93.
    Griffiths SE, Lopes T, Edmondson RJ. The role of prophylactic salpingo-oophorectomy in women who carry mutations of the BRCA genes. Obstet Gynecol. 2005;7:23–7.CrossRefGoogle Scholar
  94. 94.
    Oei AL, Massuger LF, Bulten J, Ligtenberg MJ, Hoogerbrugge N, de Hullu JA. Surveillance of women at high risk for hereditary ovarian cancer is inefficient. Br J Cancer. 2006;94(6):814–9.CrossRefPubMedGoogle Scholar
  95. 95.
    Van Nagell Jr JR, DePriest PD, Reedy MB, et al. The efficacy of transvaginal sonographic screening in asymptomatic women at risk for ovarian cancer. Gynecol Oncol. 2000;77(3):350–6.CrossRefPubMedGoogle Scholar
  96. 96.
    Woodward ER, Sleightholme HV, Considine AM, Williamson S, McHugo JM, Cruger DG. Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective. BJOG. 2007;114(12):1500–9.CrossRefPubMedGoogle Scholar
  97. 97.
    UK Familial Ovarian Cancer Screening Study (UK FOCSS). 2011; Accessed 25 Nov 2011.
  98. 98.
    Lifford KJ, Fraser L, Rosenthal AN, et al. Withdrawal from familial ovarian cancer screening for surgery: findings from a psychological evaluation study (PsyFOCS). Gynecol Oncol. 2011;124(1):158–63.CrossRefPubMedGoogle Scholar
  99. 99.
    Miller SM, Roussi P, Daly MB, Scarpato J. New strategies in ovarian cancer: uptake and experience of women at high risk of ovarian cancer who are considering risk-reducing salpingo-oophorectomy. Clin Cancer Res. 2010;16(21):5094–106.CrossRefPubMedGoogle Scholar
  100. 100.
    NIH consensus conference. Ovarian cancer. Screening, treatment, and follow-up. JAMA. 1995;273:491–7.Google Scholar
  101. 101.
    Fry A, Busby-Earle C, Rush R, Cull A. Prophylactic oophorectomy versus screening: psychosocial outcomes in women at increased risk of ovarian cancer. Psychooncology. 2001;10(3):231–41.CrossRefPubMedGoogle Scholar
  102. 102.
    Michelsen TM, Dorum A, Dahl AA. A controlled study of mental distress and somatic complaints after risk-reducing salpingo-oophorectomy in women at risk for hereditary breast ovarian cancer. Gynecol Oncol. 2009;113(1):128–33.CrossRefPubMedGoogle Scholar
  103. 103.
    Touboul C, Uzan C, Ichante JL, et al. Factors associated with altered long-term well-being after prophylactic salpingo-oophorectomy among women at increased hereditary risk for breast and ovarian cancer. Oncologist. 2011;16(9):1250–7.CrossRefPubMedGoogle Scholar
  104. 104.
    Scottish Intercollegiate Guidelines Network. Epithelial ovarian cancer: a national clinical guideline. Edinburgh: Royal College of Physicians; 2003.Google Scholar
  105. 105.
    UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). 2011; Accessed 25 Nov 2011.

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Kate Absolom
    • 1
  • Elena Takeuchi
    • 2
  • Geoff Hall
    • 3
  • Galina Velikova
    • 3
  1. 1.Psychosocial Oncology and Clinical Practice Research Group, Leeds Institute of Molecular Medicine, Division of Cancer Studies and PathologyUniversity of LeedsLeedsUK
  2. 2.Psychosocial Oncology and Clinical Practice Research GroupSt. James’s Institute of OncologyLeedsUK
  3. 3.Department of OncologyUniversity of Leeds/St. James’ Institute of OncologyLeedsUK

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