IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v45y2025i2p168-176.html

Changes in Risk Tolerance for Ovarian Cancer Prevention Strategies during the COVID-19 Pandemic: Results of a Discrete Choice Experiment

Author

Listed:
  • Brian L. Egleston

    (Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA)

  • Mary B. Daly

    (Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA)

  • Kaitlyn Lew

    (Dana-Farber Cancer Institute, Boston, MA, USA)

  • Lisa Bealin

    (Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA)

  • Alexander D. Husband

    (Dana-Farber Cancer Institute, Boston, MA, USA)

  • Jill E. Stopfer

    (Dana-Farber Cancer Institute, Boston, MA, USA)

  • Pawel Przybysz

    (Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA)

  • Olga Tchuvatkina

    (Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA)

  • Yu-Ning Wong

    (Section of Hematology and Oncology, Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
    Division of Hematology-Oncology, Perelman School of Medicine, University of Pennsylvania, USA)

  • Judy E. Garber

    (Dana-Farber Cancer Institute, Boston, MA, USA)

  • Timothy R. Rebbeck

    (Dana-Farber Cancer Institute, Boston, MA, USA
    TH Chan School of Public Health, Harvard University, Boston, MA, USA)

Abstract

Background Prior to COVID-19, little was known about how risks associated with such a pandemic would compete with and influence patient decision making regarding cancer risk reducing medical decision making. We investigated how the pandemic affected preferences for medical risk-reducing strategies among women at elevated risk of breast or ovarian cancer. Methods We conducted a discrete choice experiment. Women about to undergo genetic testing and counseling at 2 medical centers participated. Enrollment occurred between 2019 and 2022, allowing us to investigate changes in preferences from before the pandemic to after the pandemic. Women chose from permuted scenarios that specified type of surgery, age of menopause, quality of menopausal symptoms, and risk of ovarian cancer, heart disease, or osteoporosis. Results A total of 355 women, with a median age of 36 y, participated. In 2019, women were less likely to choose prevention scenarios with higher ovarian cancer risk (odds ratio [OR] = 0.42 per 10-point increase in risk, 95% confidence interval [CI] 0.22–0.61). In June 2020, the effect of higher ovarian cancer risk scenarios on choice was attenuated (OR = 0.86, 95% CI 0.68–1.04), with the effect becoming more salient again by July 2021 (OR = 0.59, 95% CI 0.52–0.67) ( P  = 0.039 for test of temporal interaction). No other attribute demonstrated a temporal trend. Conclusion The risks associated with the COVID-19 pandemic may have attenuated the impact of risk of ovarian cancer on choice of risk-reducing prevention strategies for ovarian cancer. The maximum attenuation occurred at the beginning of the pandemic when access to risk-reducing surgery was most restricted. Our findings highlight how individuals evaluate competing health risks and adjust their uptake of cancer prevention strategies when faced with a future pandemic or similar global crisis. Highlights In this discrete choice experiment, women were much less likely to choose prevention scenarios that had higher ovarian cancer risk prior to the COVID-19 pandemic than after the pandemic. The attenuation of preferences may have persisted through 2022. COVID-19 may have altered the relative importance of factors that motivate women to undergo risk-reducing surgeries.

Suggested Citation

  • Brian L. Egleston & Mary B. Daly & Kaitlyn Lew & Lisa Bealin & Alexander D. Husband & Jill E. Stopfer & Pawel Przybysz & Olga Tchuvatkina & Yu-Ning Wong & Judy E. Garber & Timothy R. Rebbeck, 2025. "Changes in Risk Tolerance for Ovarian Cancer Prevention Strategies during the COVID-19 Pandemic: Results of a Discrete Choice Experiment," Medical Decision Making, , vol. 45(2), pages 168-176, February.
    • Handle: RePEc:sae:medema:v:45:y:2025:i:2:p:168-176
    DOI: 10.1177/0272989X241302829
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X241302829
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X241302829?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. David Daeho Kim & Peter J. Neumann, 2020. "Analyzing the Cost Effectiveness of Policy Responses for COVID-19: The Importance of Capturing Social Consequences," Medical Decision Making, , vol. 40(3), pages 251-253, April.
    2. Jennifer E.C. Lee & Louise Lemyre & Louise Legault & Michelle C. Turner & Daniel Krewski, 2008. "Factor analytic investigation of Canadians' population health risk perceptions: the role of locus of control over health risks," International Journal of Global Environmental Issues, Inderscience Enterprises Ltd, vol. 8(1/2), pages 112-131.
    3. Rick L. Williams, 2000. "A Note on Robust Variance Estimation for Cluster-Correlated Data," Biometrics, The International Biometric Society, vol. 56(2), pages 645-646, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. David H Chae & Sean Clouston & Mark L Hatzenbuehler & Michael R Kramer & Hannah L F Cooper & Sacoby M Wilson & Seth I Stephens-Davidowitz & Robert S Gold & Bruce G Link, 2015. "Association between an Internet-Based Measure of Area Racism and Black Mortality," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-12, April.
    2. Krause, Werner & Giebler, Heiko, 2020. "Shifting Welfare Policy Positions: The Impact of Radical Right Populist Party Success Beyond Migration Politics," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 56(3), pages 331-348.
    3. Gerben ter Riet & Paula Chesley & Alan G Gross & Lara Siebeling & Patrick Muggensturm & Nadine Heller & Martin Umbehr & Daniela Vollenweider & Tsung Yu & Elie A Akl & Lizzy Brewster & Olaf M Dekkers &, 2013. "All That Glitters Isn't Gold: A Survey on Acknowledgment of Limitations in Biomedical Studies," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-6, November.
    4. Doidge, Craig & Andrew Karolyi, G. & Stulz, Rene M., 2007. "Why do countries matter so much for corporate governance?," Journal of Financial Economics, Elsevier, vol. 86(1), pages 1-39, October.
    5. Dave, Dhaval, 2008. "Illicit drug use among arrestees, prices and policy," Journal of Urban Economics, Elsevier, vol. 63(2), pages 694-714, March.
    6. Miozzo, Marcela & Desyllas, Panos & Lee, Hsing-fen & Miles, Ian, 2016. "Innovation collaboration and appropriability by knowledge-intensive business services firms," Research Policy, Elsevier, vol. 45(7), pages 1337-1351.
    7. Nicolas Jacquemet & Adam Zylbersztejn, 2014. "What drives failure to maximize payoffs in the lab? A test of the inequality aversion hypothesis," Review of Economic Design, Springer;Society for Economic Design, vol. 18(4), pages 243-264, December.
    8. Kuldeep Singh & Shailesh Rastogi, 2026. "Financial Distress, COVID-19 and Listed SMEs: A Multi-methodology Approach," Vision, , vol. 30(2), pages 185-199, April.
    9. Eva-Lotta Nilsson & Anna-Karin Ivert & Marie Torstensson Levander, 2021. "Adolescents´ Perceptions, Neighbourhood Characteristics and Parental Monitoring -Are they Related, and Do they Interact in the Explanation of Adolescent Offending?," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 14(3), pages 1075-1087, June.
    10. Liebig, Stefan & Schupp, Jürgen, 2008. "Leistungs- oder Bedarfsgerechtigkeit? Über einen normativen Zielkonflikt des Wohlfahrtsstaats und seiner Bedeutung für die Bewertung des eigenen Erwerbseinkommens," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 59(1), pages 7-30.
    11. Timo-Kolja Pförtner & Bart Clercq & Michela Lenzi & Alessio Vieno & Katharina Rathmann & Irene Moor & Anne Hublet & Michal Molcho & Anton Kunst & Matthias Richter, 2015. "Does the association between different dimension of social capital and adolescent smoking vary by socioeconomic status? a pooled cross-national analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(8), pages 901-910, December.
    12. Church, A. & Mitchell, R. & Ravenscroft, N. & Stapleton, L.M., 2015. "‘Growing your own’: A multi-level modelling approach to understanding personal food growing trends and motivations in Europe," Ecological Economics, Elsevier, vol. 110(C), pages 71-80.
    13. Julia R. Henly & Susan J. Lambert, 2014. "Unpredictable Work Timing in Retail Jobs," ILR Review, Cornell University, ILR School, vol. 67(3), pages 986-1016, July.
    14. Carlo Eduardo Medina-Solís & Leticia Ávila-Burgos & María de Lourdes Márquez-Corona & June Janette Medina-Solís & Salvador Eduardo Lucas-Rincón & Socorro Aida Borges-Yañez & Miguel Ángel Fernández-Bar, 2019. "Out-Of-Pocket Expenditures on Dental Care for Schoolchildren Aged 6 to 12 Years: A Cross-Sectional Estimate in a Less-Developed Country Setting," IJERPH, MDPI, vol. 16(11), pages 1-17, June.
    15. Bharath, Sreedhar & Dahiya, Sandeep & Saunders, Anthony & Srinivasan, Anand, 2007. "So what do I get? The bank's view of lending relationships," Journal of Financial Economics, Elsevier, vol. 85(2), pages 368-419, August.
    16. Valentin Dimitrov & Prem C. Jain, 2026. "Yes, Virginia, there are superstar money managers," Review of Quantitative Finance and Accounting, Springer, vol. 66(2), pages 867-886, February.
    17. Miss Nkunde Mwase, 2012. "How much should I hold? Reserve Adequacy in Emerging Markets and Small Islands," IMF Working Papers 2012/205, International Monetary Fund.
    18. Masa Trinajstic & Suzana Baresa & Sinisa Bogdan, 2018. "Regional Economic Growth And Tourism: A Panel Data Approach," UTMS Journal of Economics, University of Tourism and Management, Skopje, Macedonia, vol. 9(2), pages 145-155.
    19. Morgan, Mark Alden & Logan, Matthew William & Olma, Tayte Marie, 2020. "Police use of force and suspect behavior: An inmate perspective," Journal of Criminal Justice, Elsevier, vol. 67(C).
    20. Robert J. Wellman & Marie-Pierre Sylvestre & Erin K. O’Loughlin & Hartley Dutczak & Annie Montreuil & Geetanjali D. Datta & Jennifer O’Loughlin, 2018. "Socioeconomic status is associated with the prevalence and co-occurrence of risk factors for cigarette smoking initiation during adolescence," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(1), pages 125-136, January.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:45:y:2025:i:2:p:168-176. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.