Anxiety/Uncertainty Reduction as a Motivation for Interest in Prophylactic Oophorectomy in Women with a Family History of Ovarian Cancer

Abstract

Most women at familial risk for ovarian cancer must decide about prophylactic oophorectomy without conclusive genotypic information about their risk level. Some women with relatively low-risk profiles seek prophylactic oophorectomy or are recommended the procedure by their physicians, if they appear "cancerphobic." This study investigated the desire to reduce anxiety in relation to other factors associated with interest in prophylactic oophorectomy in a group of women with varying degrees of familial risk for ovarian cancer. Ninety-four women enrolled in an ongoing program for women with a family history of ovarian cancer received personalized risk counseling and were classified as having a sporadic, familial, or putative hereditary pedigree by a genetics counselor. Eligible enrollees were interviewed by telephone about current and future interest in prophylactic oophorectomy, perceived risk of ovarian cancer, severity of cancer anxiety, stress-related ideation, and reasons for and against surgery. Reduction of anxiety/uncertainty was the factor most strongly associated with current interest in prophylactic oophorectomy, independent of objective risk classification, perceived risk, severity of cancer anxiety, intrusive ideation, or other variables. Future interest in prophylactic oophorectomy was predicted by other perceived benefits of surgery. Current, but not future, interest in prophylactic oophorectomy appears motivated in part by seeking immediate relief from anxiety. Interest in prophylactic oophorectomy may fluctuate based on varying exposure to cues that trigger anxiety. Women seeking prophylactic oophorectomy, particularly those with lower-risk family pedigrees, should be offered options for anxiety management as part of informed consent for prophylactic oophorectomy.