Institute of Primary Care and Public Health, School of Medicine, Cardiff University, 2nd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
Fam Cancer. 2013 Mar;12(1):19-26. doi: 10.1007/s10689-012-9567-x.
Women at high risk of familial ovarian cancer face a potentially difficult risk management choice between unproven ovarian cancer screening (OCS) and bilateral salpingo-oophorectomy (BSO). It is not fully understood why women who initially opt for OCS may later undergo BSO, nor what the impact of this may be. This study explored the catalysts for surgery and reactions to discontinuing OCS. Semi-structured interviews were completed with 21 women who had undergone surgery having initially chosen OCS to explore their screening experiences, reasons for and feelings about surgery, and reactions to discontinuing OCS. The invasive nature and frequency of OCS were not by themselves a catalyst for surgery. A number of catalysts, including abnormal OCS test results, and secondary considerations, such as age-related factors, were found to prompt surgery. The emotional impact of discontinuing OCS following BSO varied between relief, acceptance, and loss of reassurance. OCS appears to be an acceptable risk management strategy under certain circumstances, but varying factors can prompt the decision to opt instead for BSO. The complexity of this management change decision should not be underestimated and needs to be taken into account by clinicians assisting women making choices. These findings highlight the importance of the timing of decision-making about BSO and that risk management options need routine reconsideration, through clinical discussions, information and support.
高危家族性卵巢癌女性在未经证实的卵巢癌筛查（OCS）和双侧输卵管卵巢切除术（BSO）之间面临着潜在的困难的风险管理选择。目前还不完全清楚为什么最初选择 OCS 的女性后来会选择 BSO，也不知道这会有什么影响。本研究探讨了手术的催化剂以及停止 OCS 的反应。对 21 名最初选择 OCS 进行筛查的接受过手术的女性进行了半结构式访谈，以探讨她们的筛查经历、手术的原因和感受，以及停止 OCS 的反应。OCS 的侵入性和频率本身并不是手术的催化剂。研究发现，包括 OCS 检测结果异常在内的多种催化剂，以及年龄相关因素等次要考虑因素，都会促使患者选择手术。BSO 后停止 OCS 的情绪反应因人而异，有人感到宽慰、接受，也有人感到失去了安慰。OCS 在某些情况下似乎是一种可以接受的风险管理策略，但不同的因素可能会促使患者选择 BSO。这种管理变更决策的复杂性不应被低估，临床医生在协助女性做出选择时需要考虑到这一点。这些发现强调了 BSO 决策时机的重要性，以及风险管理选择需要通过临床讨论、信息和支持进行常规重新考虑。
