Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: a cross-sectional study

Terra, L.; Kjoe, P.R.L.M.; Rentergem, J.A.A. van; Beekman, M.J.; Heemskerk-Gerritsen, B.A.M.; Beurden, M. van; ... ; Schagen, S.B. (2023)

Article / Letter to editor

Objective: To examine the effect of a premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer on objective and subjective cognition at least 10 years after RRSO.Design: A cross-sectional study with prospective follow-up, nested in a nationwide cohort.Setting: Multicentre in the Netherlands.Population or Sample: 641 women (66% BRCA1/2 pathogenic variant carriers) who underwent either a premenopausal RRSO <= age 45 (n = 436) or a postmenopausal RRSO >= age 54 (n = 205). All participants were older than 55 years at recruitment.Methods: Participants completed an online cognitive test battery and a questionnaire on subjective cognition. We used multivariable regression analyses, adjusting for age, education, breast cancer, hormone replacement therapy, cardiovascular risk factors and depression.Main Outcome Measures: The influence of RRSO on objective and subjective cognition of women with a premenopausal RRSO compared with women with a postmenopausal RRSO.Results: After adjustment, women with a premenopausal RRSO (mean time since RRSO 18.2 years) performed similarly on objective cognitive tests compared with women with a postmenopausal RRSO (mean time since RRSO 11.9 years). However, they more frequently reported problems with reasoning (odds ratio [OR] 1.8, 95% confidence interval [95% CI] 1.1-3.1) and multitasking (OR 1.9, 95% CI 1.1-3.4) than women with a postmenopausal RRSO. This difference between groups disappeared in an analysis restricted to women of comparable ages (60-70 years).Conclusions: Reassuringly, approximately 18 years after RRSO, we found no association between premenopausal RRSO and objective cognition.

• BRCA1/2 pathogenic variant carriers
• cognitive functioning
• premature menopause
• risk-reducing salpingo-oophorectomy

• All authors: Terra, L.; Kjoe, P.R.L.M.; Rentergem, J.A.A. van; Beekman, M.J.; Heemskerk-Gerritsen, B.A.M.; Beurden, M. van; Lennep, J.E.R. van; Doorn, H.C. van; Hullu, J.A. de; Mourits, M.J.E.; Dorst, E.B.L. van; Mom, C.H.; Slangen, B.F.M.; Gaarenstroom, K.N.; Kolk, L.E. van der; Collée, J.M.; Wevers, M.R.; Ausems, M.G.E.M.; Engelen, K. van; Beek, I. van de; Berger, L.P.V.; Asperen, C.J. van; Garcia, E.B.G.; Maas, A.H.E.M.; Hooning, M.J.; Wall, E. van der; Leeuwen, F.E. van; Schagen, S.B.
• Date: 2023-02-19
• Journal: BJOG: An International Journal of Obstetrics and Gynaecology
• Volume: 130
• Issue: 8
• Pages: 968 - 977
• DOI: doi:10.1111/1471-0528.17415
• Link: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17415