Health-related quality of life after risk-reducing hysterectomy (PRESCORES): a cross-sectional study.

Authors

Samuel George Oxley, Milly Lake, Amanda Dibden, Tia Whenham, Xia Wei, Lea Mansour, Ashwin Kalra, Subhasheenee Ganesan, Jacqueline Sia, Michail Sideris, Caitlin Fierheller, Margarida Kurzer, Rachel Perfect-Lake, Jyotsna Pundir, Ruth Armstrong, Janos Balega, Ishita Bhatnagar, Michela Cicchetti, Cecilia Compton, Jacqueline Cook, Rosemarie Davidson, Lesa Dawson, Sadaf Ghaem-Maghami, Helen Hanson, Rachel Harrison, Rachel Hart, Alison Kraus, Fiona Lalloo, D Gareth Evans, Terri P McVeigh, Kevin Monahan, Laura Monje-Garcia, Esther Moss, Alex Murray, Kai Ren Ong, Myfanwy Rawson, Dimitra Repana, Adam N Rosenthal, Neil Ryan, Lyndall Sarkies, Saba Sharif, Lucy Side, Kate Simon, Tracy Smith, Joyce Solomons, Vishakha Tripathi, Amy Watford, Mark Willett, Adam Brentnall, Rosa Legood, Ranjit Manchanda, PRESCORES study team

Published in

EClinicalMedicine. Volume 98. Pages 104083. Epub Jul 27, 2026.

Abstract

Understanding the impact of risk-reducing hysterectomy (RRH) on health-related quality-of-life is essential for informed decision-making around endometrial cancer prevention and has not been previously investigated. This study aimed to estimate health-related utilities in women who received RRH.
PRESCORES was a multicentre cross-sectional study (ISRCTN17432105). We invited 4031 UK women ≥18 years with confirmed Lynch Syndrome, without prior gynaecological cancer, to participate between May 2023 and November 2024. The main outcome was a complete-case adjusted mean-difference in EQ-5D utility scores between participants who had undergone RRH or not, and by pre/post-menopausal age groups. Quality-of-life was measured at the time of survey completion, and retrospectively 4 months after surgery in the RRH-group. The Cancer-Worry Scale instrument was also evaluated by RRH group. Sensitivity analysis considered alternative statistical methods, multiple imputation, and restricting analysis to people 35-80 years.
Analysis included 1120 participants: 529 had undergone RRH with a median age of 55 years (IQR 48-62), compared with 39 years (33-52) without RRH. The RRH-group was significantly more likely to have had cancer, physical co-morbidities, be parous and used aspirin. Adjusted mean utilities were slightly lower in the RRH than no-RRH group (difference -0.020, 95% CI -0.045 to 0.004; p = 0.11), much lower for premenopausal women (-0.041, -0.074 to -0.008), but similar for postmenopausal women (0.003, -0.036 to 0.042). Cancer-Worry-Scale scores were lower in the RRH group (mean-difference 0.48, 95% CI -0.807 to -0.157; p = 0.0037). Interpretation was robust to sensitivity analyses.
Health-related quality-of-life in women with Lynch Syndrome is likely to be lower following RRH in younger, pre-menopausal women. This is relevant for counselling, RRH decision making, and economic evaluations of women with Lynch Syndrome, with increased endometrial cancer risk.
Rosetrees Trust (CF1\100001) and Barts Charity (G-002286 and MRC0167).

PMID:
42666945
Bibliographic data and abstract were imported from PubMed on 29 Aug 2026.

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