http://archinte.jamanetwork.com/ en-us Mon, 28 Jan 2013 00:00:00 GMT Mon, 28 Jan 2013 15:51:16 GMT Silverchair editor@archinte.jamanetwork.com webmaster@archinte.jamanetwork.com http://archinte.jamanetwork.com/article.aspx?articleID=1483958 Mon, 28 Jan 2013 00:00:00 GMT Mannis GN, Fehniger JE, Creasman JS, et al. <span class="paragraphSection"><div class="boxTitle">Background</div>For women at potentially increased risk for ovarian cancer, data regarding screening and risk reduction are limited. Previous studies have reported on the behaviors of BRCA mutation carriers, but less is known about the behaviors of non- BRCA carriers. We surveyed a large cohort of women after BRCA testing to identify the prevalence and posttest predictors of risk-reducing and screening interventions.<div class="boxTitle">Methods</div>A median of 3.7 years after BRCA testing, 1447 women who received genetic counseling and BRCA testing at 2 hospital sites were surveyed, with a 77.6% response rate. We analyzed data from 1077 survey respondents. We performed univariate and multivariate logistic regression analyses to identify predictors of risk-reducing salpingo-oophorectomy (RRSO), screening transvaginal ultrasonography (TVUS), and screening serum cancer antigen 125 (CA-125).<div class="boxTitle">Results</div>Among the respondents, 201 women (18.7%) received positive test results for a deleterious mutation, 103 women (9.6%) received true-negative results, and 773 women (71.8%) received uninformative results. Overall, 19.1% of eligible women underwent RRSO and 39.6% used screening procedures. A positive BRCA result predicted RRSO (odds ratio [OR], 28.1; 95% CI, 16.2-48.6), TVUS (9.5 [4.3-21.0]), and serum CA-125 (13.0 [5.5-29.0]). Similarly, a true-negative BRCA result reduced the OR for RRSO (0.1 [0.0-0.6]), TVUS (0.2 [0.1-0.5]), and serum CA-125 (0.3 [0.1-0.7]). Of the 71.8% of women who received uninformative results after BRCA testing, 12.3% subsequently underwent RRSO, 33.8% reported ever having undergone screening serum CA-125 since BRCA testing, and 37.3% reported ever having undergone screening TVUS since BRCA testing.<div class="boxTitle">Conclusions</div>Results of BRCA testing strongly predict RRSO and ovarian cancer screening. Use of RRSO and ovarian screening was reported in a sizable percentage of non- BRCA carriers despite insufficient data to determine the effectiveness of these interventions.</span> 173 2 96 103 10.1001/2013.jamainternmed.962 http://archinte.jamanetwork.com/article.aspx?articleID=1483958 http://archinte.jamanetwork.com/article.aspx?articleID=1483960 Mon, 28 Jan 2013 00:00:00 GMT Grann V, Ashby-Thompson M. <span class="paragraphSection">Genetic history of BRCA1/2 mutations identifies women who are at high risk for breast and ovarian cancer and who may benefit from more intensive screening and/or risk-reducing surgeries. BRCA1/2 mutations account for 5% to 10% of all breast cancers in the United States and approximately 10% of ovarian cancers. Women with mutations may develop cancers at an early age, leading to psychological distress and loss of both quality and quantity of life. The cost of preventive screening and treatment for BRCA1/2 mutations accounts for approximately $800 million of the more than $8 billion spent each year for treatment of breast and ovarian cancers.</span> 173 2 103 104 10.1001/jamainternmed.2013.2729 http://archinte.jamanetwork.com/article.aspx?articleID=1483960