A woman with a long-standing fear of a significant medical condition despite negative evaluations may have which disorder?

The correct option is illness anxiety disorder. This condition involves a persistent and excessive fear or worry about having a serious illness, despite having no or minimal symptoms and negative evaluations from medical professionals. The individual often misinterprets bodily sensations or normal health processes as signs of a serious disease, which drives ongoing anxiety and concern.

In this case, the woman has a long-standing fear related to a significant medical condition while receiving negative evaluations, which aligns closely with the criteria for illness anxiety disorder. She's not primarily focused on the symptoms she may or may not have but rather on the belief that she has a serious health issue.

In contrast, somatic symptom disorder is characterized by one or more somatic symptoms that are distressing or result in significant disruption, along with excessive thoughts, feelings, or behaviors related to those symptoms. Malingering involves intentionally faking or exaggerating symptoms for a specific gain, such as financial compensation or relief from duties. Lastly, factitious disorder entails intentionally producing or feigning symptoms to assume a sick role, often without a clear external incentive. These distinctions make illness anxiety disorder the most suitable diagnosis for the scenario described.