New research sheds light on the experience of a risk-reducing hysterectomy in women with Lynch syndrome
A new UK research project led by Queen Mary University of London sheds light on the experience of risk-reducing hysterectomy in women with Lynch syndrome. Here we break down what the research found and what it means for the future.
What is Lynch syndrome?
Lynch syndrome is an inherited condition that increases a person’s risk of several types of cancer, especially colorectal, endometrial, and ovarian cancers.
It’s caused by mutations (or faults) in specific genes that are responsible for repairing DNA damage in cells. When these genes don’t work properly, errors in DNA replication occur, leading to genetic instability. This instability increases the chance of cells becoming cancerous.
Lynch syndrome increases the risk of endometrial (womb) cancer to around 13–49% lifetime risk, and also increases the risk of ovarian and colorectal cancer. Lynch syndrome accounts for 3% of endometrial cancer cases. You can read more about Lynch syndrome here.
Due to their increased risks, women with Lynch syndrome are advised to have a risk-reducing hysterectomy (removal of their womb) to prevent endometrial (womb) cancer, usually alongside bilateral salpingo-oophorectomy (removal of ovaries and fallopian tubes) to reduce ovarian cancer risk. It is recommended this surgery is done between ages 35-40 and having this surgery before natural menopause means going into menopause early.
What did the research project set out to do?
The PRESCORES study (Preventing Endometrial Cancer: Utility Scores of Risk-Reducing Strategies) looked at how having a risk- reducing hysterectomy impacts women with Lynch syndrome. Involving 25 NHS trusts in England, Scotland, and Wales, the project specifically looked at the impact on quality of life following surgery to remove the womb (hysterectomy) to prevent endometrial cancer, as well as the impact on cancer-related worry.
What did the study find?
The researchers found that pre-menopausal women with Lynch syndrome who had risk-reducing hysterectomy reported a lower quality-of-life than premenopausal women without hysterectomy, but there was no difference in older (post-menopausal) women.
The researchers suggest this is due to the impact of salpingo-oophorectomy (removal of ovaries and fallopian tubes) done alongside the hysterectomy, and the resulting early menopause.
Women who had risk-reducing hysterectomy were found to have lower cancer-related worry than women who didn't, and the researchers noted that this worry has a negative impact on quality of life.
What does this mean for the future?
The researchers noted that since only around 5% of Lynch syndrome carriers have been identified, the sample of women involved in this study may not be truly representative of the population, but this study does shine a light on the need for counselling before surgery so women understand the potential impact on quality of life as well as the reduction in cancer risk.
You can read the full journal article here
