Ovarian Ca screening: Needed in non-BRCA carriers?

A study published online by the Archives of Internal Medicine reports that women who are screened for the BRCA gene and found not to be carriers often undergo ovarian Ca screening, despite the fact that the lifetime risk of developing ovarian cancer is only 1% to 2% in the general population.

The cumulative lifetime risk of developing ovarian Ca is approximately 40% in BRCA1 carriers and approximately 20% in BRCA2 carriers, note the study authors.

Gabriel N. Mannis, MD, and colleagues with the University of California, San Francisco, surveyed 1077 women after BRCA testing to identify the prevalence and post-test predictors of risk-reducing and screening interventions, including risk-reducing salpingo-oophorectomy (RRSO), screening transvaginal ultrasound (TVS), and screening serum Ca antigen 125.

The women’s BRCA test results were categorized as positive (shown to carry known deleterious BRCA mutation), true-negative (negative test result for a known deleterious family BRCA mutation), uninformative negative (negative BRCA results without a known family mutation), or variant of undetermined significance (found to have a change in DNA that has unknown effects on BRCA protein function).

Among the women studied, 201 (18.7%) received positive test results for a deleterious mutation, 103 (9.6%) received true-negative test results, and 773 (71.8%) received uninformative results.

Overall, 19.1% of eligible women underwent RRSO and 39.6% used screening procedures. Women who received a positive BRCA test result had increased odds of undergoing RRSO, TVS and serum CA-125, while a true-negative BRCA result was associated with reduced odds of undergoing the 3 procedures.

However, 30.2% of women with uninformative BRCA results and 9.6% of women with true-negative BRCA results reported having undergone ovarian Ca screening.

“Results of BRCA testing strongly predict RRSO and ovarian cancer screening,” the study authors concluded. “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.”