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Familial Cancer

, Volume 14, Issue 1, pp 51–60 | Cite as

The impact of risk-reducing gynaecological surgery in premenopausal women at high risk of endometrial and ovarian cancer due to Lynch syndrome

  • Ramona Moldovan
  • Sianan Keating
  • Tara Clancy
Original Article

Abstract

Women with Lynch syndrome (LS) have a significantly increased lifetime risk of endometrial cancer (40–60 %) and ovarian cancer (7–12 %). Currently there is little evidence to support the efficacy of screening for the early detection of these cancers. Another option is risk-reducing hysterectomy and/or bilateral salpingo-oophorectomy (BSO). Research on the impact of BSO in premenopausal women with a non-LS associated family history cancer has generally shown that women have a high level of satisfaction about their decision to undergo surgery. However, debilitating menopausal symptoms and sexual dysfunction are common post-surgical problems. We used a mixed methods study to explore the impact of risk-reducing gynaecological surgery in women with LS: 24 women were invited to take part; 15 (62.5 %) completed validated questionnaires and 12 (50 %) participated in semi-structured interviews. Our results suggest that risk reducing surgery does not lead to significant psychological distress and the women tend not to think or worry much about developing cancer. However, they tend to be distressed about the physical and somatic symptoms associated with menopause; their social well-being is somewhat affected, but sexual difficulties are minimal. The women reported being overwhelmingly satisfied with their decision to have surgery and with the quality of information they received prior to the operation. However, they felt underprepared for menopausal symptoms and received conflicting advice about whether or not to use HRT. Recommendations from the study include that professionals discuss the menopause, its side effects and HRT in detail prior to surgery.

Keywords

Lynch syndrome Psychosocial impact Risk reducing surgery Endometrial cancer Ovarian cancer 

Notes

Acknowledgments

The authors would like to thank the women who agreed to participate in this study for all their time and effort.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The study has been approved by Northwest 6 Research Ethics Committee, Greater Manchester and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants gave their informed consent prior to their inclusion in the study. All details that might disclose the identity of the participants have been omitted.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Ramona Moldovan
    • 1
    • 2
  • Sianan Keating
    • 2
    • 3
  • Tara Clancy
    • 2
    • 4
  1. 1.Department of PsychologyBabes-Bolyai UniversityCluj-NapocaRomania
  2. 2.University of ManchesterManchesterUK
  3. 3.Department of Clinical GeneticsUniversity Hospital Bristol, Trust HeadquartersBristolUK
  4. 4.Manchester Centre for Genomic Medicine, Saint Mary’s HospitalCentral Manchester University Hospitals NHS Foundation TrustManchesterUK

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