PURPOSE: While dramatic advances in cancer genetics and the identification of cancer susceptibility genes such as BRCA1/2 have occurred, little research has been carried out with individuals and their family members at risk for breast and/or ovarian cancer about how they make decisions regarding inherited cancer risk information. The purpose of this study was to test a family decision making model that addresses both individual and family level variables in a population-based sample and to determine what variables may be predictive of individual and family member decision making regarding inherited cancer risk information. METHODS: A descriptive, cross-sectional design was conducted with 146 breast and/or ovarian cancer survivors and 146 unaffected first, second, or third degree female relatives (N=292). Using the transtheoretical model of change and a family stress framework, a population-based sample, stratified by race (Caucasian and African-American) and by diagnosis (breast and ovarian), was randomly selected from the NCI SEER Cancer Registry in southeastern Michigan. Standardized instruments with adequate reliability and validity were used to measure study variables: family history of cancer, coping styles, knowledge of cancer risk, self-efficacy, family communication, social support, perception of cancer risk, cancer worries, readiness to change and decisional balance. Analyses included descriptive statistics and hierarchical linear modeling. RESULTS: Preliminary results indicate there are differences with family dyads with strong cancer history scores. Families with these higher cancer history scores reported both higher perceptions of cancer risk and more benefits toward seeking inherited cancer risk information. Additionally, the higher one family member's risk score (both survivor and unaffected female relative), the more likely was the other's decision to seek cancer risk information. However, most individuals were predominantly in the pre-contemplation or contemplation stages in their decision making and readiness to change about seeking inherited cancer risk information, and few had moved to a taking action stage to obtain more risk information. CONCLUSIONS: Findings suggest that at risk individuals and families may be contemplating a decision to seek cancer risk information but are not moving toward taking action. Results also indicate that individuals (both cancer survivors and unaffected relatives) influence each other's decisions to seek cancer risk information. More research is needed to understand and assist individuals and families in making informed decisions about their cancer risk.