Understanding risk perception and risk-reducing decision-making for surgery among individuals with a genetic predisposition to epithelial ovarian cancer

Sep 22, 2026

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Genetic predisposition to hereditary breast and ovarian cancer and Lynch syndrome increases the risk of developing cancer, including epithelial ovarian cancer (EOC). Based on pathogenic variants, EOC risk varies widely and many individuals are offered risk-reducing salpingo-oophorectomy (RRSO). This convergent mixed-methods study used an online survey and virtual interviews (63 surveys, 20 interviews) to examine how people interpret personal risk and decide on RRSO. Objective risk information was shaped by experiential knowledge, perceived control, cancer worry, and factors including family planning, hormonal impacts, and recovery; providers influenced decisions directly and indirectly.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

Introduction

Risk prediction, cancer outcomes, and screening limitations

Decision-making context for RRSO

Study aims and methods

Convergent mixed-methods design: survey and interviews

DOI: 10. 1002/jgc4 .70225 OR I G I NAL ART I C L E Understanding risk perception and risk-reducing decisionmaking for surgery among individuals with a genetic predisposition to epithelial ovarian cancer Rebekah Kukurudz-Gorowski1 | Sylvia Horn1 | Pascal Lambert2,3 | Kim Serfas1,4 | Renée El-Gabalawy3,5,6 | Alon David Altman3,7 | Kirk James McManus1,3 | Jessica Nicole Hartley1 | Mark William Nachtigal1,3,7 1Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada 2Department of Epidemiology, CancerCare Manitoba, Winnipeg, Manitoba, Canada 3 Paul Albrechtsen Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada 4Shared Health Program of Genetics and Metabolism, Health Sciences Centre, Winnipeg, Manitoba, Canada 5Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada 6Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada 7Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada Correspondence Rebekah Kukurudz-Gorowski, Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB, Canada. Email: [rebekah.kukurudz@umanitoba.ca](rebekah.kukurudz@umanitoba.ca) Abstract Genetic predisposition to hereditary breast and ovarian cancer and Lynch syndrome increases the risk of developing cancer, including epithelial ovarian cancer (EOC). Depending on the pathogenic variant, (e.g., BRCA1 or PMS2) the risk of developing EOC ranges from approximately 3%–60% . To reduce this risk, many individuals are offered risk-reducing salpingo-oophorectomy (RRSO), a procedure in which fallopian tubes and ovaries are removed. Some centers have dedicated programs that provide targeted care for individuals at risk of gynecologic cancers, such as the Hereditary Gynecology Clinic in Winnipeg, Manitoba. To better understand how individuals across a spectrum of risk values for developing EOC interpret their personal risk and make decisions regarding RRSO, we conducted a convergent mixed-methods study involving an online survey and virtual interview. Sixty-three surveys and twenty interviews were completed. Participants viewed objective risk information as a starting point, to which‘experiential knowledge’ and perceived control were applied and integrated into their personal subjective risk assessment. Perceived risk was intertwined with cancer worry, and individuals made decisions regarding RRSO based on factors such as perceived risk, control, family planning, hormonal impacts, and recovery. Importantly, healthcare providers exerted both direct and indirect influences on the decision-making process. K E Y WO R D S decision-making, epithelial ovarian cancer, HBOC, Lynch syndrome, risk perception, RRSO 1 | INTRODUCTION Epithelial ovarian cancer (EOC) is the third most common gynecologic cancer globally (Sung et al., 2021), with a prevalence of approximately 1 in 78 individuals in Canada (Canadian Cancer Statistics, 2025) . The predicted 5-year net survival for EOC in Canada is 44%, with increased survival for individuals with earlier staging at the time of diagnosis (Canadian Cancer Statistics, 2025) . Unfortunately, most EOC cases remain undiagnosed until late stage, making EOC the deadliest gynecologic malignancy. Up to 25% of EOC cases are associated with This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2026 The Author(s) . Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors. J Genet Couns. 2026;35:e70225 . [https://doi.org/10.1002/jgc4.70225](https://doi.org/10.1002/jgc4.70225) [wiley

FAQs

What procedure is discussed as a risk-reducing option for epithelial ovarian cancer?

The study focuses on risk-reducing salpingo-oophorectomy (RRSO), in which fallopian tubes and ovaries are removed to reduce EOC risk.

How did participants interpret their personal risk when making RRSO decisions?

Participants used objective risk information as a starting point, then integrated “experiential knowledge” and perceived control into a subjective risk assessment.

Which factors influenced participants’ decisions about RRSO?

Decisions were linked to perceived risk, cancer worry, perceived control, family planning needs, hormonal impacts, and recovery considerations.

Sep 22, 2026

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