Moldovan Ramona, Keating Sianan, Clancy Tara
Department of Psychology, Babes-Bolyai University, No. 37 Republicii Street, 400015, Cluj-Napoca, Romania,
Fam Cancer. 2015 Mar;14(1):51-60. doi: 10.1007/s10689-014-9761-0.
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.
患有林奇综合征（LS）的女性一生中患子宫内膜癌（40%-60%）和卵巢癌（7%-12%）的风险显著增加。目前，几乎没有证据支持筛查对这些癌症早期检测的有效性。另一种选择是进行降低风险的子宫切除术和/或双侧输卵管卵巢切除术（BSO）。关于BSO对有非LS相关家族性癌症病史的绝经前女性的影响的研究总体表明，女性对接受手术的决定满意度很高。然而，令人衰弱的更年期症状和性功能障碍是常见的术后问题。我们采用混合方法研究来探讨降低风险的妇科手术对LS女性的影响：邀请了24名女性参与；15名（62.5%）完成了经过验证的问卷，12名（50%）参与了半结构化访谈。我们的结果表明，降低风险的手术不会导致显著的心理困扰，而且这些女性往往不会过多思考或担心患癌症的问题。然而，她们往往会因与更年期相关的身体和躯体症状而感到困扰；她们的社会幸福感受到了一定影响，但性方面的困难最小。这些女性报告说，她们对自己的手术决定以及术前获得的信息质量非常满意。然而，她们觉得对更年期症状准备不足，并且在是否使用激素替代疗法（HRT）方面得到了相互矛盾的建议。该研究的建议包括，专业人员在手术前应详细讨论更年期、其副作用和HRT。
