{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:10:37Z","timestamp":1773288637379,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,1,20]],"date-time":"2012-01-20T00:00:00Z","timestamp":1327017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic>Manchanda R, Burnell M, Abdelraheim A, Johnson M, Sharma A, Benjamin E, Brunell C, Saridogan E, Gessler S, Oram D, Side L, Rosenthal A, Jacobs I, Menon U. Factors influencing uptake and timing of risk reducing salpingo\u2010oophorectomy in women at risk of familial ovarian cancer: a competing risk time to event analysis. BJOG 2012;119:527\u2013536.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold>To evaluate factors affecting uptake of risk\u2010reducing salpingo\u2010oophorectomy (RRSO) over time in women at high\u2010risk of familial ovarian cancer.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold>Prospective observational cohort.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold>Tertiary high\u2010risk familial gynaecological cancer clinic.<\/jats:p><jats:p><jats:bold>Population\/sample\u2002<\/jats:bold>New clinic attendees between March 2004 and November 2009, fulfilling the high\u2010risk criteria for the UK Familial Ovarian Cancer Screening Study.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold>Risk management options discussed included RRSO and ovarian surveillance. Outcome data were analysed from a bespoke database. The competing risk method was used to model the cumulative incidence function (CIF) of RRSO over time, and the sub\u2010hazard ratio (SHR) was used to assess the strength of the association of variables of interest with RRSO. Gray\u2019s test was used to evaluate the difference in CIF between two groups and multivariable competing risk regression analysis was used to model the cumulative probabilities of covariates on the CIF.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold>Of 1133 eligible women, 265 (21.4%) opted for RRSO and 868 (69.9%) chose screening. Women undergoing RRSO were older (49\u2003years, interquartile range 12.2\u2003years) than those preferring screening (43.4\u2003years, interquartile range 11.9\u2003years) (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.0005). The CIF for RRSO at 5\u2003years was 0.55 (95% CI 0.45\u20130.64) for<jats:italic>BRCA1\/2<\/jats:italic>carriers and 0.22 (95% CI 0.19\u20130.26) for women of unknown mutation status (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.0001); 0.42 (95% CI 0.36\u20130.47) for postmenopausal women (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.0001); 0.29 (95% CI 0.25\u20130.33) for parity \u22651 (<jats:italic>P<\/jats:italic>\u2003=\u20030.009) and 0.47 (95% CI 0.39\u20130.55) for a personal history of breast cancer (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.0001). Variables of significance from the regression analysis were: a<jats:italic>BRCA1\/2<\/jats:italic>mutation (SHR 2.31, 95% CI 1.7\u20133.14), postmenopausal status (SHR 2.16, 95% CI 1.62\u20132.87)) and a personal history of breast cancer (SHR 1.5, 95% CI 1.09\u20132.06).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold>Decision\u2010making is a complex process and women opt for surgery many years after initial risk assessment.<jats:italic>BRCA<\/jats:italic>carriers, postmenopausal women and women who had breast cancer are significantly more likely to opt for preventative surgery.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2011.03257.x","type":"journal-article","created":{"date-parts":[[2012,1,20]],"date-time":"2012-01-20T11:07:51Z","timestamp":1327057671000},"page":"527-536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Factors influencing uptake and timing of risk reducing salpingo\u2010oophorectomy in 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