Background. Little is known about the factors that women at increased risk of ovarian cancer consider to be important when deciding about prophylactic oophorectomy, surgery to remove the ovaries before they develop cancer.\ud \ud Methods. Women who had undergone prophylactic oophorectomy (surgical group; n = 30) were compared with women who remained on the ovarian screening program (nonsurgical group; n = 28) on their importance ratings for a number of relevant decision-making factors.\ud \ud Results. The most important decision-making factor across all subjects was reducing risk of ovarian cancer, but the single best predictor of group membership was the importance attributed to reducing cancer worry. Women who rated this factor as more important were more likely to be in the surgical group. No women identified the increased risk of heart disease and osteoporosis as issues for consideration.\ud \ud Conclusions. The desire to reduce cancer worry is likely to be the most important factor in a woman's decision to proceed to prophylactic oophorectomy. In view of the current imprecision in risk estimates given to women considering this option, cancer worry may override a more rational consideration of the costs and benefits of surgery
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