Finding a Pathogenic Mutation on Genetic Testing Does Not Add to Stress or Anxiety in Women with Newly Diagnosed Ovarian Cancer

Web Exclusives - Ovarian Cancer

Genetic testing results do not adversely affect patient-reported quality of life (QOL) among women with newly diagnosed ovarian cancer. While finding a pathogenic mutation on panel testing had no negative impact on QOL, “negative genetic testing results may allay anxiety for women with ovarian cancer,” concluded investigators of a study of 83 women who had an ovarian cancer diagnosis and underwent genetic testing. Their data were reported in a poster presentation at the 2020 American Society of Clinical Oncology Virtual Scientific Program.

The investigators, led by Sarah S. Lee, MD, Resident, Department of Obstetrics and Gynecology, New York University School of Medicine, New York City, compared patient-reported stress, anxiety, and depression among women who were referred by gynecologic oncologists for genetic counseling and genetic testing as part of a facilitated referral pathway.

Of the 110 women enrolled in the pathway, 83 (76%) underwent genetic testing, and 15 (18%) were found to have potentially actionable pathogenic mutations and 26 (31%) had variants of unknown significance (VUS). Three (4%) had both a pathogenic mutation and a VUS. Forty-two (51%) had negative results on genetic testing.

A total of 60 of 76 English-speaking women completed 3 QOL instruments before and after genetic testing, with 37 completing the QOL assessment at 6 to 9 months post-genetic testing.

In the entire cohort, the results from genetic testing did not affect QOL scales across all time points. All women demonstrated mild stress at each time point and clinically significant anxiety immediately following genetic testing.

Among the entire cohort, a statistically significant decrease in Hospital Anxiety and Depression Scale (HADS) depression scores was observed over time from pre-genetic testing to 6 months post-genetic testing (mean score, 4.98 vs 2.97; P = .020). Patients with VUS had lower HADS mean anxiety scores across time (3.62) compared with patients with pathogenic mutations (7.44) or patients who tested negative (6.83) (P = .029).

Among the patients who tested negative for mutations, there was a significant decrease in clinically significant anxiety by State-Trait Anxiety Inventory score at 6 months (P = .002) and a decrease in borderline anxiety by HADS scores at 6 months (P = .005). No such decreases were found among patients with pathogenic mutations or VUS.

“Patients should be recommended genetic testing at time of diagnosis of ovarian cancer without concern of increased stress, anxiety, or depression based on genetic testing results,” the investigators concluded.

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Last modified: July 28, 2020