The genetic threshold for surgery to prevent ovarian cancer should be reduced, experts say today.
The procedure, risk reducing salpingo-oophorectomy, may be offered to women over the age of 40 if they have a lifetime risk of 10% of contracting the disease.
But, according to a new analysis, this should be reduced to 4%.
The lifetime risk is assessed on the basis of first degree relatives who succumb to the disease and through the presence of genes such as BRCA1, BRCA2, RAD51C, RAD51D and BRIP1.
The analysis, in the Journal of Medical Genetics, analysed the cost of surgery and the benefits in QALYs.
The researchers say reducing the risk limit to 4% would add around 43 extra days of life expectancy.
Led by Dr Ranjit Manchanda, of the Barts Cancer Institute, London, UK, they write: “Our results are of major significance for clinical practice and risk management in view of declining genetic testing costs and the improvements in estimating an individual’s ovarian cancer risk.
“With routine clinical testing for certain moderate penetrance genes around the corner and lack of an effective ovarian cancer screening programme, these findings are timely as they provide evidence supporting a surgical prevention strategy for lower risk individuals."
Specifying the ovarian cancer risk threshold of premenopausal risk-reducing salpingo-oophorectomy for ovarian cancer prevention: a cost effectiveness analysis. Journal of Medical Genetics 28 June 2016; doi 10.1136/jmedgenet-2016-103800 [abstract]
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