Surveillance Feasible for Women Deferring Prophylactic Salpingo-Oophorectomy
WEDNESDAY, Nov. 2, 2022 (HealthDay News) — For women deferring risk-reducing bilateral salpingo-oophorectomy (RRSO), surveillance for ovarian cancer (OC) is feasible, yields a high complete cytoreduction rate, and is cost-saving, according to a study published online Nov. 1 in the Journal of Medical Genetics.
Susan Philpott, from the University College London Hospitals NHS Foundation Trust, and colleagues examined the performance and cost-effectiveness of OC surveillance in women with pathogenic germline BRCA1/2 variants who defer RRSO. A total of 875 female BRCA1/2 heterozygotes were recruited; 767 underwent at least one four-monthly surveillance test with the Risk of Ovarian Cancer Algorithm test.
The researchers identified eight OCs during 1,277 women screen-years: two occult OCs at RRSO (stage 1a) and six screen-detected (three ≤ stage 3a), five of which were completely surgically cytoreduced. The modeled sensitivity and specificity for OC was 87.5 and 99.9 percent, respectively; the positive predictive value was 75 percent and negative predictive value was 99.9 percent. The gain in predicted number of quality-adjusted life years was 0.179 with surveillance; the incremental cost-effectiveness ratio cost-saving was −£102,496/quality-adjusted life year.
“Such surveillance should be viewed strictly as a short-term option only, as unlike RRSO it cannot prevent OC,” the authors write. “Women undergoing such surveillance should be counselled extensively about its limitations, and that delaying RRSO indefinitely could result in diagnosis with an incurable OC.”
Several authors disclosed financial ties to biopharmaceutical companies, including Abcodia, which funded the study.