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Updated: Apr 1, 2026

Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
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Personalized Decision-Making in Risk-Reducing Surgery of the Ovaries.

Mary B Daly1, Brian L Egleston2, Kaitlyn Lew3

  • 1Department of Clinical Genetics, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania.

JAMA Network Open
|March 31, 2026
PubMed
Summary

Premenopausal women weigh risks for ovarian cancer surgery. Factors like family history and menopause symptoms influence decisions, with risk-reducing salpingo-oophorectomy often preferred.

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Area of Science:

  • Gynecologic Oncology
  • Decision Science
  • Genetic Counseling

Background:

  • Premenopausal women with hereditary or familial risk for ovarian cancer face complex decisions regarding risk-reducing surgery.
  • Understanding the factors influencing these decisions is crucial for effective patient counseling and support.

Purpose of the Study:

  • To assess the key factors motivating premenopausal women to choose risk-reducing surgery for ovarian cancer.
  • To investigate how different attributes of surgical outcomes and risks influence decision-making.

Main Methods:

  • A discrete choice experiment was employed with 355 premenopausal women at high risk for ovarian cancer.
  • Conjoint analysis evaluated preferences for risk-reducing salpingo-oophorectomy (RRSO) versus risk-reducing salpingectomy (RRS) or observation, considering various risk factors and menopausal outcomes.

Main Results:

  • Women showed a preference for RRSO over RRS or observation.
  • Risks of osteoporosis and heart disease, along with the desire for natural menopause and milder symptoms, significantly impacted choices.
  • A family history of ovarian cancer increased the preference for RRSO.

Conclusions:

  • Women can effectively weigh competing risks when considering ovarian cancer risk-reduction strategies.
  • Counseling models should address the complexity of these decisions and offer personalized guidance to support informed choices.