Prevention of ovarian cancer: a survey of the practice of prophylactic oophorectomy by consultant gynaecologists in Ireland.

The aim of this study was to investigate attitudes to prophylactic oophorectomy among practicing consultant gynaecologists in Ireland. An anonymous questionnaire was sent to 90 practicing consultants. A total of 68 replies were received (76%). Of these, the number who said they would remove apparently normal ovaries at the time of abdominal hysterectomy from premenopausal women in age groups < 35, 35-39, 40-44, 45-49 and > 49 years was 0 (0%), 0 (0%), 4 (6%), 29 (43%), and 46 (68%) respectively; and from postmenopausal women 60 (88%). Only 2 (3%) routinely considered oophorectomy when performing a vaginal hysterectomy. The majority of respondents said that (i) they would prescribe hormone replacement therapy in premenopausal oophorectomised women (98.5%); (ii) they did not consider unilateral oophorectomy to have a role in the prevention of ovarian cancer (84%); and (iii) they routinely discussed the question of prophylactic oophorectomy with their patients preoperatively (82%). Only 19 (27%) believed that the established figure of 10-15% of ovarian cancers could be prevented by oophorectomy at the time of hysterectomy for benign disease. 43 (63%) would perform prophylactic oophorectomy as a primary surgical procedure in women with a strong family history of ovarian carcinoma.