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Risk perception, worry, and test acceptance in average-risk women who undergo ovarian cancer screening - 24/02/14

Doi : 10.1016/j.ajog.2013.11.022 
Laura L. Holman, MD a, Karen H. Lu, MD a, , Robert C. Bast, MD b, Mary A. Hernandez, RN, MSN b, Diane C. Bodurka, MD a, Steven Skates, PhD c, Charlotte C. Sun, DrPH, MPH a
a Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 
b Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 
c Biostatistics Center, Massachusetts General Hospital, Boston, MA 

Reprints: Karen H. Lu, MD, The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology- Unit 1362, 1155 Herman Pressler, CPB6.3244, Houston, TX 77030-3721.

Abstract

Objective

We evaluated baseline knowledge of ovarian cancer risk and perceptions toward ovarian cancer screening (OCS) by initiating the normal risk ovarian screening study.

Study Design

Average-risk, postmenopausal women were enrolled between 2001 and 2011 as they entered the normal risk ovarian screening study. Participants completed baseline surveys of risk perception, cancer worry (Cancer Worry Scale), anxiety (State-Trait Anxiety Inventory), health and well-being survey (SF-36 HEALTH SURVEY), and acceptability of OCS.

Results

Of the 1242 women who were enrolled, 925 women (74.5%) completed surveys. The respondents estimated a mean lifetime risk of ovarian cancer of 29.9%, which is much higher than the actual risk of 1.4% for women in the United States. Only 2.8% of participants correctly estimated their risk; 35.4% of the participants reported their lifetime risk to be ≥50%. Cancer worry was low, with a median Cancer Worry Scale score of 7 of 24. Anxiety was comparable with published norms for women in this age group, with median STAI-State and STAI-Trait scores of 30 and 29 of 80, respectively. Overall, women reported good physical and mental well-being. In terms of OCS acceptability, 97.2% of respondents agreed or strongly agreed that “the benefits of screening outweigh the difficulties.” Very few women were reluctant to undergo OCS because of time constraints (1.1%), pain (2.0%), or embarrassment (1.9%).

Conclusion

Average-risk women who underwent OCS highly overestimated their risk of ovarian cancer. Despite this, participants reported low cancer worry and anxiety. The discrepancy between knowledge of and attitudes toward ovarian cancer risk highlights the need for educational efforts in this area.

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Key words : acceptability of screening, cancer worry, ovarian cancer screening, risk perception


Mappa


 Supported by funds from the M.D. Anderson SPORE in Ovarian Cancer, NCI P50 CA83639, and grant number T32 CA101642 from a National Institutes of Health National Research Service Award, the Bioinformatics Shared Resources of the MD Anderson CCSG NCI P30 CA16672, the National Foundation for Cancer Research, philanthropic support from Golfers Against Cancer, the Tracey Jo Wilson Foundation, the Mossy Foundation, the Norton family, and Stuart and Gaye Lynn Zarrow; and in part by grant number CA152990 from National Cancer Institute's Early Detection Research Network (S.S.).
 The contents of this study report are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or National Institutes of Health.
 R.C.B. receives royalties for CA125 from Fujirebio Diagnostics Inc (Malvern, PA) and honoraria from Vermillion Inc (Austin, TX) for service on their Scientific Advisory Board; S.S. is a faculty member at Massachusetts General Hospital, which has licensed the Risk of Ovarian Cancer Algorithm. All other authors report no conflict of interest.
 Cite this article as: Holman LL, Lu KH, Bast RC, et al. Risk perception, worry, and test acceptance in average-risk women who undergo ovarian cancer screening. Am J Obstet Gynecol 2014;210:257.e1-6.


© 2014  Pubblicato da Elsevier Masson SAS.
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