Preemptive surgery helps some cancer-prone women

NEW YORK (Reuters Health) - Women with a genetic mutation that gives rise to colorectal cancer -- a condition called the Lynch syndrome -- are also at high risk for endometrial and ovarian cancer. Investigators now report that preventive hysterectomy and removal of the ovaries is effective in preventing these gynecologic cancers in such cases.

Dr. Karen H. Lu, from University of Texas M. D. Anderson Cancer Center in Houston, and her associates report the findings in the New England Journal of Medicine for January 19th.

In 1997, experts concluded there was insufficient evidence to recommend preemptive gynecologic surgery for women with Lynch syndrome.

To re-assess this option, Lu's group evaluated outcomes among women with the genetic mutation. The study included 61 women who underwent prophylactic hysterectomy matched with 210 controls of similar age, and 47 women who underwent prophylactic ovary removal and 223 controls.

There were no cases of endometrial cancer among women who underwent hysterectomy, and 69 in the comparison group. Similarly, there were no cases of ovarian cancer among women who underwent ovary removal versus 12 cases among the "controls".

These findings support consideration of preemptive hysterectomy and ovary removal for women with the Lynch syndrome "once childbearing has been completed," Lu's group advises.

However, they add, "Patients should be advised of the trade-offs between the reduction in the risk of cancer and the risks and side effects of surgery."

SOURCE: New England Journal of Medicine, January 19, 2006.