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The question stem break up is as under..
Conclusion: There is lots of variation in the frequency of many surgical procedures
Support: Up to ten fold variation per hundred thousand between different areas in the numbers of hysterectomes, prostratectomies and tosclectomes....
Required: staement which support that variation is not due to geographies but that most of these surgical procedures is unnecessary.
A--if a board is considering whether operation is needed, then there is a less chance that unnecessary oprations will be conducted. Out.
B--there are certain factors that may lead to surgery in one area, but not in other. this is a possible choice.
C--other than what is mentioned is out of scope.
D--what happens, or what is needed, after the opration is not in question. it is what should have been considered before the opration.
E--these are the key, but still don't explain why variation is there.