Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Department of Medicine, Yale University School of Medicine, New Haven, CT.
JCO Glob Oncol. 2024 Oct;10:e2400097. doi: 10.1200/GO.24.00097. Epub 2024 Oct 31.
Women with pathogenic variants (PVs) in breast cancer (BC) and ovarian cancer (OC) associated genes are candidates for cancer risk-reducing strategies. Limited information is available regarding risk-reducing surgeries (RRS) among Hispanics. The aim of this study was to describe the uptake of RRS in an international real-world experience of Hispanic women referred for genetic cancer risk assessment (GCRA) and to identify factors affecting uptake.
Between July 1997 and December 2019, Hispanic women, living in the United States or in Latin America, enrolled in the Clinical Cancer Genomics Community Research Network registry were prospectively included. Demographic characteristics and data regarding RRS were obtained from chart reviews and patient-reported follow-up questionnaires. Median follow-up was 41 months.
Among 1,736 Hispanic women referred for GCRA, 27.2% women underwent risk-reducing mastectomy (RRM), 25.5% risk-reducing salpingo-oophorectomy (RRSO) and, 10.7% both surgeries. Among carriers, rates of RRM and RRSO were 47.6% and 56.7%, respectively. In the multivariate analyses, being a carrier of a BC susceptibility gene (odds ratio [OR], 3.44), personal history of BC (OR, 6.22), living in the US (OR, 3.90), age ≤50 years (OR, 1.68) and, family history of BC (OR, 1.56) were associated with a higher likelihood of undergoing RRM. Carrying an OC susceptibility gene (OR, 6.72) was associated with a higher likelihood of undergoing RRSO.
The rate of RRS among Hispanic women is suboptimal. PV carriers, women with personal history of cancer, and those with a family history of cancer were more likely to have RRS, with less uptake outside the US. Understanding personal and systemic factors influencing uptake may enable interventions to increase risk appropriate uptake of RRS.
患有乳腺癌（BC）和卵巢癌（OC）相关基因致病性变异（PVs）的女性是实施癌症风险降低策略的候选者。有关西班牙裔人群实施降低风险手术（RRS）的信息有限。本研究的目的是描述在接受遗传癌症风险评估（GCRA）的西班牙裔女性国际真实世界经验中，RRS 的采用情况，并确定影响采用率的因素。
1997 年 7 月至 2019 年 12 月，前瞻性纳入美国或拉丁美洲居住的、参与临床癌症基因组社区研究网络注册的西班牙裔女性。从病历回顾和患者报告的随访问卷中获得人口统计学特征和 RRS 数据。中位随访时间为 41 个月。
在 1736 名接受 GCRA 的西班牙裔女性中，27.2%的女性接受了预防性乳房切除术（RRM），25.5%接受了预防性输卵管卵巢切除术（RRSO），10.7%的女性同时接受了这两种手术。在 携带者中，RRM 和 RRSO 的发生率分别为 47.6%和 56.7%。在多变量分析中，携带 BC 易感性基因（比值比 [OR]，3.44）、个人 BC 病史（OR，6.22）、居住在美国（OR，3.90）、≤50 岁（OR，1.68）和 BC 家族史（OR，1.56）与 RRM 可能性增加相关。携带 OC 易感性基因（OR，6.72）与 RRSO 可能性增加相关。
西班牙裔女性 RRS 的比例不理想。携带 PV 者、有癌症个人病史者以及有癌症家族史者更有可能进行 RRS，而在美国境外的接受率较低。了解影响接受率的个人和系统因素可能有助于实施干预措施，以提高风险适当接受 RRS。
