Cancer Anxiety Mediates the Association Between Satisfaction With Medical Communication and Psychological Quality of Life After Prophylactic Bilateral Salpingo-Oophorectomy.

Agostino Brugnera,Maria Grazia Strepparava,Cristina Zarbo,Chiara Malandrino,Robert Fruscio,Valentina Dessì,Isadora Vaglio Tessitore,Mariangela Ventura,Federica Paola Sina,Chiara Celi,Rosalba Giordano,Luigi Frigerio,Angelo Compare

doi:10.3389/fpsyg.2022.840931

Abstract

BackgroundProphylactic Bilateral Salpingo-Oophorectomy (PBSO) reduces the risk of developing ovarian cancer. However, the psychological mechanisms that may affect post-surgery Quality of Life (QoL) among patients who underwent PBSO are still largely unknown. Thus, this study aimed at exploring the direct and indirect associations of satisfaction with medical communication and cancer anxiety on post-surgery QoL among women at high risk of developing ovarian cancer.MethodFifty-nine women (mean age: 50.64 ± 6.7 years) who underwent PBSO took part in this cross-sectional study, filling out a sociodemographic and clinical questionnaire, a battery of validated psychological measures and an ad hoc developed scale for the assessment of cancer anxiety. We first examined the correlations among all variables of interest, and then tested if cancer anxiety mediated the association between satisfaction with medical communication and post-surgery psychological QoL, controlling both for time from surgery and education.ResultsPost-surgery psychological QoL was unrelated from any sociodemographic or clinical variable. Cancer anxiety had a significant direct negative effect on psychological QoL, while satisfaction with medical communication had a significant positive direct effect on it. Finally, cancer anxiety significantly mediated the association between satisfaction with medical communication and post-surgery psychological QoL.DiscussionResults suggest that post-surgery psychological QoL of patients who underwent PBSO may be increased with interventions, delivered in a genetic counselling setting, targeting quality of medical communication and cancer anxiety.

Highlights

IntroductionOvarian cancer accounts for an estimated 239,000 new cases and 152,000 deaths worldwide (Ferlay et al, 2015)
Each year, ovarian cancer accounts for an estimated 239,000 new cases and 152,000 deaths worldwide (Ferlay et al, 2015)
Post-surgery psychological Quality of Life (QoL) was unrelated from sociodemographic and clinical variables, nor from the time passed since prophylactic surgery

Summary

Introduction

Ovarian cancer accounts for an estimated 239,000 new cases and 152,000 deaths worldwide (Ferlay et al, 2015). Despite recent improvements in detection and treatment, mortality is still high and data relating to its distribution are still alarming In this context, genetic tests that evaluate the inherited tendency to develop ovarian cancer are useful, as they allow to prevent cancer’s onset and, to reduce the mortality rates (Bleiker et al, 2003). Recent studies have shown that women with the BRCA (BReast CAncer) gene 1 or 2 mutation have a significantly increased lifetime risk of developing both breast (from 39 to 85%) and/or ovarian cancer (from 10 to 63%) (Ford et al, 1998; Meijers-Heijboer et al, 2001; Antoniou et al, 2003). Surgery (i.e., prophylactic mastectomy and/or prophylactic bilateral salpingo-oophorectomy) is recommended as it substantially reduces the risk of developing breast or ovarian cancer (Schrag et al, 1997; Meijers-Heijboer et al, 2001). This study aimed at exploring the direct and indirect associations of satisfaction with medical communication and cancer anxiety on post-surgery QoL among women at high risk of developing ovarian cancer

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