{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:04:52Z","timestamp":1790179492889,"version":"4.1.0"},"reference-count":29,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"abstract":"\n Importance<\/jats:title>\n \n Women with a\n BRCA1<\/jats:italic>\n or\n BRCA2<\/jats:italic>\n variant face a high lifetime risk of ovarian cancer and are often advised to undergo preventive surgery (bilateral salpingo-oophorectomy [BSO]) before cancer develops. The recommended age of BSO is 35 years for\n BRCA1<\/jats:italic>\n carriers and is 45 years for\n BRCA2<\/jats:italic>\n carriers, but some women choose to delay surgery until the age of menopause; there is no standard upper age at which surgery is no longer advised.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To estimate the residual lifetime risk of ovarian cancer among BRCA carriers by current age and projected age at BSO.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n \n This was a prospective cohort study in an international cohort of BRCA carriers monitored for incident ovarian cancer. A life table analysis used age-specific ovarian cancer incidence rates and competing mortality rates to estimate lifetime risk of ovarian cancer among women with a\n BRCA1<\/jats:italic>\n or\n BRCA2<\/jats:italic>\n pathogenic variant with both ovaries intact and no prior ovarian cancer at baseline. Patients were recruited between 1995 and 2024 across 24 international centers, and the mean (SD) follow-up was 4.4 (3.9) years.\n <\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Timing of BSO, defined as immediate BSO, delayed BSO, or no BSO.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n Residual lifetime risk of ovarian cancer.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cohort consisted of 4286\n BRCA1<\/jats:italic>\n and 1427\n BRCA2<\/jats:italic>\n carriers between the ages of 30 and 74 years at baseline (mean [SD] age, 42.0 [10.8] years). There were 249 incident ovarian cancers in the follow-up period. The lifetime risk of ovarian cancer was 55.0% (95% CI, 48.8-61.9) for a\n BRCA1<\/jats:italic>\n carrier and 24.1% (95% CI, 15.1-36.6) for a\n BRCA2<\/jats:italic>\n carrier. A 30-year-old\n BRCA1<\/jats:italic>\n carrier with BSO delayed to age 50 years had a projected residual ovarian cancer risk of 23.9% (95% CI, 20.7-27.4). At age 75 years, the residual risk of ovarian cancer was estimated to be 8.4% (95% CI, 1.7-22.7) for a\n BRCA1<\/jats:italic>\n carrier and 3.7% (95% CI, 0.1-22.7) for a\n BRCA2<\/jats:italic>\n carrier.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n The residual risk of ovarian cancer for older women in good health is sufficiently high to consider preventive surgery.\n BRCA1<\/jats:italic>\n carriers who defer BSO until age 50 years may face a substantial risk of developing ovarian cancer.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamasurg.2026.4356","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:30:29Z","timestamp":1790177429000},"source":"Crossref","is-referenced-by-count":0,"title":["Projected Benefit of Bilateral Salpingo-Oophorectomy by Age in BRCA Carriers"],"prefix":"10.1001","author":[{"given":"Vasily","family":"Giannakeas","sequence":"first","affiliation":[{"name":"Women\u2019s College Research and 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