kjwhn Korean Journal of Women Health Nursing Korean J Women Health Nurs 2287-1640 2093-7695 Korean Society of Women Health Nursing 10.4069/kjwhn.2019.25.4.365 kjwhn-25-365 Original Article Knowledge and Anxiety Related to Hereditary Ovarian Cancer in Serous Ovarian Cancer Patients LeeSang Hee 1 2 LeeHyangkyu 3 LimMyong Cheol 4 KimSue 3 Student, College of Nursing, Yonsei University, Seoul, Korea Nurse, Uterine Ovarian Cancer Center, National Cancer Center, Goyang, Korea Professor, College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea Professor, Uterine Ovarian Cancer Center, National Cancer Center, Goyang, Korea Corresponding author: Sue Kim College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2228-3276 Fax: +82-2227-8303 E-mail: suekim@yuhs.ac 122019 19122019 25 4 365 378 08082019 22112019 25112019 Copyright © 2019 Korean Society of Women Health Nursing 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose

The awareness of hereditary breast and ovarian cancer (HBOC) and BRCA testing is increasing in Korea. Compared to the sizable research on HBOC knowledge among breast cancer women, studies in the ovarian cancer population are limited. This paper aimed to investigate the level of knowledge of hereditary ovarian cancer and anxiety in women diagnosed with serous ovarian cancer in Korea and determine differences in the knowledge and anxiety according to whether genetic testing was undertaken and whether BRCA1 or BRCA2 mutations were present.

 Methods

Using a descriptive research design, a cross-sectional survey was conducted on 100 women diagnosed with serous ovarian cancer at N hospital in Gyeonggi-do, Korea, from July to November 2018. The collected data were analyzed by descriptive statistics, independent t-tests, one-way analysis of variance, and Pearson’s correlation coefficient using the SPSS 21.0 program.

 Results

The hereditary ovarian cancer-related knowledge score was mid-level (mean score 8.90±3.29 out of a total of 17), as was the state anxiety level was mid-level (mean score 47.96±3.26 out of possible score range of 20–80). Genetic knowledge of hereditary ovarian cancer was associated with age, education, occupation, genetic counseling, and BRCA mutations. There were no statistically significant factors related to anxiety and there were no statistically significant correlations between knowledge level and anxiety.

 Conclusion

More comprehensive education on gene-related cancer is needed for ovarian cancer patients, especially for items with low knowledge scores. A genetic counseling protocol should be developed to allow more patients to alleviate their anxiety through genetic counseling.

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Participant Characteristics (N=100)

Variable Categories Total (n=100) BRCA positive (n=36) BRCA negative (n=36) Not tested (n=28)
M±SD or n(%) M±SD or n(%) M±SD or n(%) M±SD or n(%)
Age (year) Range: 27–77 54.60±10.94
<50 32 (32.0) 18 (50.0) 6 (16.7) 8 (28.6)
50–59 36 (36.0) 11 (30.6) 16 (44.4) 9 (32.1)
≥60 32 (32.0) 7 (19.4) 14 (38.9) 11 (39.3)
Education ≤Middle school 15 (15.0) 4 (11.1) 4 (11.1) 7 (25.0)
High school 41 (41.0) 14 (38.9) 17 (47.2) 10 (35.7)
≥College 44 (44.0) 18 (50.0) 15 (41.7) 11 (39.3)
Occupation Yes 73 (73.0) 24 (66.7) 30 (83.3) 19 (67.9)
No 27 (27.0) 12 (33.3) 6 (16.7) 9 (32.1)
Marital status Married 76 (76.0) 28 (77.8) 27 (75.0) 21 (75.0)
Unmarried & other 24 (24.0) 8 (22.2) 9 (25.0) 7 (25.0)
Monthly family income (10,000 won) <200 33 (33.0) 12 (33.3) 10 (27.8) 11 (39.3)
200–399 35 (35.0) 8 (22.2) 16 (44.4) 11 (39.3)
≥400 32 (32.0) 16 (44.4) 10 (27.8) 6 (21.4)
Seeking disease-related information† Internet 53 (53.0) 19 (52.8) 20 (55.6) 14 (50.0)
TV, radio 26 (26.0) 11 (30.6) 6 (16.7) 9 (32.1)
Book 5 (5.0) 2 (5.6) 1 (2.8) 2 (7.1)
Other patients 14 (14.0) 5 (13.9) 5 (13.9 4 (14.3)
Medical staff 32 (32.0) 12 (33.3) 11 (36.0) 9 (32.1)
Sharing disease-related information† Spouse 66 (66.0) 25 (69.4) 23 (63.9) 18 (64.3)
Sibling 44 (44.0) 17 (47.2) 17 (47.2) 10 (35.7)
Parents 16 (16.0) 8 (22.2) 5 (13.9) 3 (10.7)
Children 49 (49.0) 15 (41.7) 24 (66.7) 10 (35.7)
Cousin 7 (7.0) 3 (8.3) 1 (2.8) 3 (10.7)
No 1 (1.0) 1 (2.8) 0 (0.0) 0 (0.0)
Sharing genetic test results† Spouse 39 (39.0) 21 (55.6) 18 (50.0)
Sibling 34 (34.0) 19 (52.8) 15 (41.7)
Parents 11 (11.0) 7 (19.4) 4 (11.1)
Children 42 (42.0) 17 (44.4) 25 (69.4)
Cousin 4 (4.0) 4 (11.1) 0 (0.0)
No 4 (4.0) 3 (8.3) 1 (2.8)
Received genetic counseling Yes 19 (19.0) 16 (44.4) 3 (8.3) 0 (0.0)
No 81 (81.0) 20 (55.6) 33 (91.7) 28 (100)
Secondary cancer screening† Breast self-examination 11 (11.0) 5 (13.9) 3 (8.3) 3 (11.1)
Clinical breast examination 20 (20.0) 11 (30.6) 4 (11.1) 5 (18.5)
Mammography or MRI 19 (19.0) 9 (25.0) 6 (16.7) 4 (14.8)
EGD 22 (22.0) 6 (16.7) 9 (25.0) 7 (25.9)
Colonoscopy 19 (19.0) 5 (13.9) 8 (22.2) 6 (22.2)
No 54 (54.0) 17 (47.2) 21 (58.3) 16 (59.3)
Current chemo status Yes 86 (86.0) 33 (89.2) 29 (78.4) 24 (64.9)
No 14 (14.0) 3 (8.1) 7 (18.9) 4 (10.8)
Time from diagnosis (year) Range: 0.08–10.5 1.00±1.58
<1 56 (56.0) 24 (66.7) 26 (72.2) 16 (44.4)
1–2 20 (20.0) 7 (19.4) 7 (19.4) 6 (16.7)
>2 14 (14.0) 5 (13.9) 3 (8.3) 6 (16.7)
Disease stage During 1st therapy 61 (61.0) 15 (41.7) 21 (58.3) 25 (89.3)
NED 6 (6.0) 0 (0.0) 5 (13.9) 1 (3.6)
AWD 33 (33.0) 32 (58.3) 10 (27.8) 2 (7.1)
Cancer staging I 6 (6.0) 0 (0.0) 4 (11.1) 2 (7.1)
II 10 (10.0) 2 (5.6) 3 (8.3) 5 (17.9)
III 60 (60.0) 24 (66.7) 21 (58.3) 15 (53.6)
IV 24 (24.0) 10 (27.8) 8 (22.2) 6 (21.4)

BRCA=breast cancer susceptibility gene; NED=no evidence of disease; AWD=alive with disease, MRI=magnetic resonance imaging; EGD=esophagogastroduodenoscopy;.

M±SD=mean±standard deviation.

Multiple response.

Participants’ Genetic Ovarian Cancer Knowledge and Anxiety (N=100)

Variable Categories M±SD Min Max F p Scheffé test
Genetic ovarian cancer knowledge Total 8.90±3.29 0 16 4.63 .012 a>c
BRCA positivea 9.83±3.65 1 16
BRCA negativeb 9.11±2.64 5 14
Not testedc 7.43±3.14 0 12
State anxiety Total 47.96±3.26 41 58 0.00 .992
BRCA positive 47.86±2.78 42 56
BRCA negative 47.67±3.38 41 58
Not tested 48.39±3.71 43 56

BRCA=breast cancer susceptibility gene; M±SD=mean±standard deviation.

Participants’ Genetic Ovarian Cancer Knowledge (N=100)

Abbreviated description of items Correct rate (%) Error rate (%) Don’t know (%)
1. When a mother gets ovarian cancer, her daughter gets ovarian cancer. 34 35 31
2. A father can pass down the ovarian cancer gene mutation to his daughters. 28 21 51
3. The probability that a woman with ovarian cancer gene mutation will pass on this gene to her child is 50%. 47 15 38
4. If a mother or sister of a woman with ovarian cancer has ovarian cancer, it is hereditary ovarian cancer. 19 58 23
5. A woman with a family history of ovarian cancer should receive frequent ovarian cancer screening more often than normal, even if she does not have a genetic mutation. 7 86 7
6. If the mother has a genetic mutation, all her daughters will have mutations. 38 33 29
7. A mother can pass down the ovarian cancer gene mutation to her son. 35 19 46
8. All women who have the ovarian cancer gene mutation will get cancer. 45 29 26
9. If a mother has an ovarian cancer gene mutation, her child and other immediate family member will need ovarian cancer screening. 91 4 5
10. Mutations in ovarian cancer genes can increase the risk of developing cancer in other parts of the body. 69 8 23
11. About half of all ovarian cancers are hereditary. 37 25 38
12. A woman who does not have an ovarian cancer gene mutation can still get ovarian cancer. 84 2 14
13. A women with a ovarian cancer gene mutation has an increased risk of breast cancer. 64 6 30
14. If there is a genetic mutation of ovarian cancer, examinations for ovarian cancer should be done periodically. 95 1 4
15. If there is a genetic mutation of ovarian cancer, examinations for breast cancer should be done periodically. 72 5 23
16. Without the ovarian cancer gene mutation, there is no need to have regular ovarian cancer screening. 76 14 10
17. A man who carries the ovarian cancer gene mutation has an increased risk of prostate cancer and colorectal cancer. 49 5 46

Differences in Genetic Ovarian Cancer Knowledge and Anxiety according to Participants’ Characteristics (N=100)

Variable Categories Genetic ovarian cancer knowledge State anxiety
M±SD t or F p Scheffé M±SD t or F p
Age (year) <50a 10.72±3.01 10.12 <.001 a>b,c 47.78±2.56 0.26 .770
50–59b 8.67±3.06 47.33±3.45
≥60c 7.34±2.99 48.84±3.57
Education ≤Middle schoola 7.13±3.70 3.65 .029 c>a 48.33±4.10 1.12 .330
High schoolb 8.71±3.05 48.41±3.28
≥Collegec 9.68±3.17 47.41±2.92
Occupation Yes 9.32±2.90 −2.10 .068 48.21±3.42 −1.23 .219
No 7.78±4.02 47.30±2.75
Marital status Married 8.70±3.20 −1.09 .276 47.70±3.23 −1.43 .154
Unmarried & others 9.54±3.56 48.79±3.31
Monthly family income (10,000 won) <200 8.36±3.53 0.65 .520 48.33±3.47 0.35 .700
200–399 9.11±3.10 47.89±2.96
≥400 9.22±3.27 47.66±3.43
Received genetic counseling Yes 10.53±3.67 −2.45 .016 47.74±1.99 0.32 .743
No 8.52±3.09 48.01±3.50
Secondary cancer screening† Breast self-examination Yes 8.73±3.34 −0.13 .898 47.81±3.06 −0.13 .896
No 8.87±3.34 47.96±3.30
Clinical Breast examination Yes 10.45±3.87 2.46 .015 48.55±3.17 0.93 .352
No 8.45±3.07 47.79±3.28
Mammography or MRI Yes 9.84±3.13 1.45 .150 48.21±2.85 0.40 .690
No 8.62±3.34 47.88±3.36
EGD Yes 9.18±2.66 0.52 .599 47.95±3.24 0.02 .981
No 8.76±3.50 47.94±3.28
Colonoscopy Yes 9.37±3.11 0.75 .453 48.57±3.87 0.94 .345
No 8.73±3.38 47.79±3.10
At least one test 9.43±3.35 −1.63 .105 48.61±3.44 −1.91 .058
Not all tests 8.35±3.25 47.37±3.01
Current chemo status Yes 8.89±3.31 −0.33 .737 47.82±3.54 0.86 .387
No 8.57±3.52 48.64±3.22
Time from diagnosis (year) <1 9.15±3.11 0.86 .422 48.33±3.47 0.35 .700
1–2 8.45±3.47 47.89±2.96
>2 8.00±4.09 47.66±3.43
Disease stage During 1st therapy 8.77±3.02 2.47 .090 47.65±3.22 1.22 .298
NED 5.83±3.43 48.05±3.06
AWD 8.52±3.14 49.14±3.63
Cancer staging I 7.33±4.36 0.87 .459 45.51±3.50 0.44 .643
II 9.80±4.18 44.33±3.61
III 8.48±2.89 45.70±2.68
IV 8.33±2.94 44.88±4.03
Genetic test & gene mutation state BRCA positivea 9.83±3.65 4.63 .012 a>c 47.92±2.81 4.79 .679
BRCA negativeb 9.11±2.64 47.67±3.38
Not testedc 7.43±3.14 48.39±3.71

BRCA=breast cancer susceptibility gene; NED=no evidence of disease; AWD=alive with disease; MRI=magnetic resonance imaging;

EGD=esophagogastroduodenoscopy; M±SD=mean±standard deviation.

Multiple response.

Relationship between Genetic Knowledge and State Anxiety (N=100)

Variable State anxiety
r (p)
Genetic knowledge −.31 (.091)