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

L. Terra; P.R.L.M. Kjoe; J.A.A. van Rentergem; M.J. Beekman; B.A.M. Heemskerk-Gerritsen; M. van Beurden; J.E.R. van Lennep; H.C. van Doorn; J.A. de Hullu; M.J.E. Mourits; E.B.L. van Dorst; C.H. Mom; B.F.M. Slangen; K.N. Gaarenstroom; L.E. van der Kolk; J.M. CollTe; M.R. Wevers; M.G.E.M. Ausems; K. van Engelen; I. van de Beek; L.P.V. Berger; C.J. van Asperen; E.B.G. Garcia; A.H.E.M. Maas; M.J. Hooning; E. van der Wall; F.E. van Leeuwen; S.B. Schagen

doi:10.1111/1471-0528.17415

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

L. Terra, P.R.L.M. Kjoe, J.A.A. van Rentergem, M.J. Beekman, B.A.M. Heemskerk-Gerritsen, M. van Beurden, J.E.R. van Lennep, H.C. van Doorn, J.A. de Hullu, M.J.E. Mourits, E.B.L. van Dorst, C.H. Mom, B.F.M. Slangen, K.N. Gaarenstroom, L.E. van der Kolk, J.M. CollTe, M.R. Wevers, M.G.E.M. Ausems, K. van Engelen, I. van de BeekL.P.V. Berger, C.J. van Asperen, E.B.G. Garcia, A.H.E.M. Maas, M.J. Hooning, E. van der Wall, F.E. van Leeuwen^*, S.B. Schagen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

Original language	English
Pages (from-to)	968-977
Number of pages	10
Journal	Bjog-an International Journal of Obstetrics and Gynaecology
Volume	130
Issue number	8
Early online date	1 Feb 2023
DOIs	https://doi.org/10.1111/1471-0528.17415
Publication status	Published - Jul 2023

Keywords

BRCA1/2 pathogenic variant carriers
cognitive functioning
premature menopause
risk-reducing salpingo-oophorectomy
DEMENTIA
MENOPAUSE
ESTROGEN
BREAST
IMPAIRMENT

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10.1111/1471-0528.17415

Cite this

Terra, L., Kjoe, P. R. L. M., van Rentergem, J. A. A., Beekman, M. J., Heemskerk-Gerritsen, B. A. M., van Beurden, M., van Lennep, J. E. R., van Doorn, H. C., de Hullu, J. A., Mourits, M. J. E., van Dorst, E. B. L., Mom, C. H., Slangen, B. F. M., Gaarenstroom, K. N., van der Kolk, L. E., CollTe, J. M., Wevers, M. R., Ausems, M. G. E. M., van Engelen, K., ... Schagen, S. B. (2023). Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study. Bjog-an International Journal of Obstetrics and Gynaecology, 130(8), 968-977. https://doi.org/10.1111/1471-0528.17415

@article{b1a68c49cc2741eb99db805bbf007131,

title = "Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study",

abstract = "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.",

keywords = "BRCA1/2 pathogenic variant carriers, cognitive functioning, premature menopause, risk-reducing salpingo-oophorectomy, DEMENTIA, MENOPAUSE, ESTROGEN, BREAST, IMPAIRMENT",

author = "L. Terra and P.R.L.M. Kjoe and {van Rentergem}, J.A.A. and M.J. Beekman and B.A.M. Heemskerk-Gerritsen and {van Beurden}, M. and {van Lennep}, J.E.R. and {van Doorn}, H.C. and {de Hullu}, J.A. and M.J.E. Mourits and {van Dorst}, E.B.L. and C.H. Mom and B.F.M. Slangen and K.N. Gaarenstroom and {van der Kolk}, L.E. and J.M. CollTe and M.R. Wevers and M.G.E.M. Ausems and {van Engelen}, K. and {van de Beek}, I. and L.P.V. Berger and {van Asperen}, C.J. and E.B.G. Garcia and A.H.E.M. Maas and M.J. Hooning and {van der Wall}, E. and {van Leeuwen}, F.E. and S.B. Schagen",

note = "Funding Information: The Dutch Cancer Society (KWF) granted funding for this project, registered under grant 10164. This study was peer‐reviewed by the Dutch Cancer Society and several patient panels before granting funding. The funding body had no role in the design of the study, collection, analysis, and interpretation of data or in writing the article. Publisher Copyright: {\textcopyright} 2023 John Wiley & Sons Ltd.",

year = "2023",

month = jul,

doi = "10.1111/1471-0528.17415",

language = "English",

volume = "130",

pages = "968--977",

journal = "Bjog-an International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "Wiley",

number = "8",

}

Terra, L, Kjoe, PRLM, van Rentergem, JAA, Beekman, MJ, Heemskerk-Gerritsen, BAM, van Beurden, M, van Lennep, JER, van Doorn, HC, de Hullu, JA, Mourits, MJE, van Dorst, EBL, Mom, CH, Slangen, BFM, Gaarenstroom, KN, van der Kolk, LE, CollTe, JM, Wevers, MR, Ausems, MGEM, van Engelen, K, van de Beek, I, Berger, LPV, van Asperen, CJ, Garcia, EBG, Maas, AHEM, Hooning, MJ, van der Wall, E, van Leeuwen, FE & Schagen, SB 2023, 'Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study', Bjog-an International Journal of Obstetrics and Gynaecology, vol. 130, no. 8, pp. 968-977. https://doi.org/10.1111/1471-0528.17415

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.; van Rentergem, J.A.A. et al.
In: Bjog-an International Journal of Obstetrics and Gynaecology, Vol. 130, No. 8, 07.2023, p. 968-977.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study

AU - Terra, L.

AU - Kjoe, P.R.L.M.

AU - van Rentergem, J.A.A.

AU - Beekman, M.J.

AU - Heemskerk-Gerritsen, B.A.M.

AU - van Beurden, M.

AU - van Lennep, J.E.R.

AU - van Doorn, H.C.

AU - de Hullu, J.A.

AU - Mourits, M.J.E.

AU - van Dorst, E.B.L.

AU - Mom, C.H.

AU - Slangen, B.F.M.

AU - Gaarenstroom, K.N.

AU - van der Kolk, L.E.

AU - CollTe, J.M.

AU - Wevers, M.R.

AU - Ausems, M.G.E.M.

AU - van Engelen, K.

AU - van de Beek, I.

AU - Berger, L.P.V.

AU - van Asperen, C.J.

AU - Garcia, E.B.G.

AU - Maas, A.H.E.M.

AU - Hooning, M.J.

AU - van der Wall, E.

AU - van Leeuwen, F.E.

AU - Schagen, S.B.

N1 - Funding Information: The Dutch Cancer Society (KWF) granted funding for this project, registered under grant 10164. This study was peer‐reviewed by the Dutch Cancer Society and several patient panels before granting funding. The funding body had no role in the design of the study, collection, analysis, and interpretation of data or in writing the article. Publisher Copyright: © 2023 John Wiley & Sons Ltd.

PY - 2023/7

Y1 - 2023/7

N2 - 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.

AB - 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.

KW - BRCA1/2 pathogenic variant carriers

KW - cognitive functioning

KW - premature menopause

KW - risk-reducing salpingo-oophorectomy

KW - DEMENTIA

KW - MENOPAUSE

KW - ESTROGEN

KW - BREAST

KW - IMPAIRMENT

U2 - 10.1111/1471-0528.17415

DO - 10.1111/1471-0528.17415

M3 - Article

C2 - 36715559

SN - 1470-0328

VL - 130

SP - 968

EP - 977

JO - Bjog-an International Journal of Obstetrics and Gynaecology

JF - Bjog-an International Journal of Obstetrics and Gynaecology

IS - 8

ER -

Terra L, Kjoe PRLM, van Rentergem JAA, Beekman MJ, Heemskerk-Gerritsen BAM, van Beurden M et al. Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study. Bjog-an International Journal of Obstetrics and Gynaecology. 2023 Jul;130(8):968-977. Epub 2023 Feb 1. doi: 10.1111/1471-0528.17415