SCREENING FOR OVARIAN CANCER--PSYCHOBEHAVIORAL OUTCOMES

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Early detection of ovarian cancer (OC) is critical to management of the disease. While transvaginal sonography (TVS) is the preferred screening modality for OC, concerns have been raised regarding the cost/benefit ratio associated with TVS. While TVS has been shown to facilitate early detection of OC, TVS yields a high proportion of "abnormal" findings. These findings require additional follow-up in the form of repeat TVS testing or exploratory surgery. While the vast majority of these abnormal findings are ultimately determined to be "false positives," the impact of this potentiallly stressful experience upon a woman's cognition, affect, and behavior has not been adequately examined. This study will use a prospective, longitudinal design to examine psychological and behavioral outcomes associated with TVS screening for OC. Three groups of women will be studied: women undergoing an initial TVS test who receive a normal result (n=300), women undergoing an initial TVS test who receive an abnormal result (n=300), and a matched group of healthy women who have never undergone TVS testing (n=300). Assessments will be conducted prior to initial TVS test and at 2 week, and 4, 18, and 30 month followups. Guided by the conceptual framework provided by both the Cognitive-Social Health Information Processing (C-SHIP) and Monitoring Process Models, endpoints to be examined include cognition (e.g., risk perception, perceptions of TVS efficacy, intrusive and avoidant ideation), affect (e.g., depression, mood disturbance), and behavior (adherence to routine follow-up TVS testing). Research aims include: (1) characterization of women who undergo TVS screening; (2) identification of psychological and behavioral outcomes associated with TVS screening; and (3) identification of clinical, demographic, and psychological variables associated with post-TVS psychological and behavioral outcomes. Regarding the latter aim, hypotheses regarding the relationship between informational coping style (e.g., high monitoring) and post-TVS psychological and behavioral outcomes will be tested. Results will enable development of interventions to enhance psychological and behavioral outcomes after TVS screening for OC.