Theory‐based behavior change intervention to increase uptake of risk‐reducing salpingo‐oophorectomy in women with a BRCA1 or BRCA2 pathogenic variant: The PREVENT randomized controlled trial

Abstract

Abstract Objective To evaluate the effect of a theory‐based behavioral intervention delivered by genetic counselors on the uptake of risk‐reducing salpingo‐oophorectomy (RRSO) at 12 and 24 months by women with a BRCA1 or BRCA2 pathogenic variant (PV) compared to women who received usual care. Methods In this two‐arm, multi‐site randomized controlled trial participants were randomized to receive a theoretically‐guided behavioral telephone intervention or usual care. Outcome data were collected at 12 and 24 months. Participants in the usual care arm were offered the intervention after 12 months. Results Data on 107 participants were included in the analysis. There was no significant difference in the proportion of women who had a RRSO by 1 year (28.6%‐ intervention; 22.9%‐ usual care (p = 0.54)). At 1 year, women who received the intervention had significantly lower mean decisional conflict (pinteraction <0.001) and a higher mean knowledge score at one‐year compared to usual care (pinteraction <0.001). At 2 years, 53.9% of participants in the intervention arm had RRSO compared to 32.6% in usual care (p = 0.05). Conclusions A theory‐based behavioral intervention delivered by genetic counselors to women with a BRCA PV who chose not to have the recommended RRSO was effective at reducing decisional conflict and increasing knowledge in women with a BRCA1 or BRCA2 PV.

Keywords

• BRCA1
• BRCA2
• cancer genetics
• cancer prevention
• clinical management