Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan.
Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Sci Rep. 2023 Jan 19;13(1):1018. doi: 10.1038/s41598-023-28304-w.
To determine the impact of the coverage of risk-reducing salpingo-oophorectomy (RRSO) and mastectomy (RRM) as well as genetic testing for BRCA pathogenic variants by the national insurance system in Japan. We compared the clinical background of women who underwent RRSO at our institution before and after its coverage by the national insurance system. Those who underwent RRSO between January 2017 and December 2019 and between April 2020 and March 2022 were classified as Period. A and B, respectively. Overall, 134 women underwent RRSO during the study period. In Period A and B, 45 and 89 women underwent RRSO for the study period was 36 and 24 months, respectively. Compared with Period A, the number of women who underwent RRSO per month increased by threefold in Period B (p < 0.01). In addition, the number of women who underwent surgery for breast cancer along with RRSO increased in Period B (p < 0.01). Although the number of women who underwent concurrent RRM with RRSO in Period B increased, the difference was not statistically significant. Compared with Period A, the number of women diagnosed with BRCA pathogenic variant increased by 3.9-fold, and the proportion of women who underwent concurrent hysterectomy at the time of RRSO decreased from 66 to 7.9% in Period B (p < 0.01). Owing to the introduction of the national insurance system, the number of women who underwent RRSO and concurrent surgery for breast cancer at the time of RRSO increased in Japan.
为了确定日本国家保险制度对降低风险的输卵管卵巢切除术（RRSO）和乳房切除术（RRM）以及 BRCA 致病性变异体的遗传检测的覆盖范围的影响。我们比较了在国家保险制度覆盖前后在我们机构接受 RRSO 的女性的临床背景。在 2017 年 1 月至 2019 年 12 月和 2020 年 4 月至 2022 年 3 月期间接受 RRSO 的女性分别归类为时期 A 和 B。共有 134 名女性在研究期间接受了 RRSO。在时期 A 和 B 中，分别有 45 名和 89 名女性接受 RRSO 的研究期间分别为 36 个月和 24 个月。与时期 A 相比，时期 B 中每月接受 RRSO 的女性数量增加了两倍（p<0.01）。此外，在时期 B 中，与 RRSO 同时接受乳腺癌手术的女性人数增加（p<0.01）。尽管在时期 B 中同时接受 RRSO 和 RRM 的女性人数有所增加，但差异无统计学意义。与时期 A 相比，诊断为 BRCA 致病性变异体的女性数量增加了 3.9 倍，同期 RRSO 时同时行子宫切除术的女性比例从 66%下降至 7.9%（p<0.01）。由于国家保险制度的引入，日本接受 RRSO 和同期乳腺癌手术的女性人数有所增加。
