What increases the risk of ovarian cancer?
Ovarian cancer risk factors include:
Getting older
The risk of developing ovarian cancer increases with age. Most ovarian cancers develop after menopause. In the United States, the average age of menopause is 51.
Most people diagnosed with ovarian cancer are 55 or older. Although ovarian cancer is rare in people younger than 40, it can occur at any age.
Overweight or obesity
Obesity has been linked to a higher risk of several cancers, including ovarian cancer. Research suggests that having a higher body mass index, or BMI, may modestly increase the risk of developing ovarian cancer.
BMI is one measurement used to assess body weight in relation to height. However, it does not provide a complete picture of a person’s health or individual cancer risk.
Childbirth later in life or never having a full-term pregnancy
Having a first full-term pregnancy after age 35 or never carrying a pregnancy to term may increase the risk of ovarian cancer.
Pregnancy temporarily stops ovulation. Researchers believe that having fewer total ovulations during a person’s lifetime may help lower ovarian cancer risk.
Hormone replacement therapy
Hormone replacement therapy, also called HRT or menopausal hormone therapy, may be used to help relieve symptoms of perimenopause or menopause.
Research suggests that current or recent use of menopausal hormone therapy may slightly increase the risk of ovarian cancer. The level of risk may depend on the type of hormone therapy, how long it is used, and other individual health factors.
Talk with your health care provider about the potential benefits and risks of hormone therapy based on your medical history.
Family history of ovarian cancer, breast cancer, or colorectal cancer
Certain cancers can occur more frequently within families. Having a first-degree relative, such as a parent, sibling, or child, who has or had ovarian cancer may increase your risk.
A family history of breast cancer, colorectal cancer, fallopian tube cancer, or primary peritoneal cancer may also indicate an increased risk of ovarian cancer.
In some families, these cancers are connected to an inherited genetic mutation or hereditary cancer syndrome. Learning about your family health history can help you and your health care provider better understand your risk.
Personal history of breast cancer
If you have or previously had breast cancer, you may have an increased risk of developing ovarian cancer.
Breast cancer and ovarian cancer share some risk factors. For example, inherited mutations in genes such as BRCA1 and BRCA2 can increase the risk of both cancers.
Endometriosis
Endometriosis is a condition in which tissue similar to the lining of the uterus grows in other areas of the body.
A history of endometriosis may modestly increase the risk of developing certain types of ovarian cancer. According to the American Cancer Society, the association is strongest for ovarian clear cell carcinoma, also called OCCC, and endometrioid ovarian carcinoma.
Having endometriosis does not mean that you will develop ovarian cancer. The overall risk remains low, but people with endometriosis should discuss their individual health history and concerns with a health care provider.
Inherited genetic mutations
Genes contain instructions that help cells function normally. Some genes help repair damaged DNA and prevent cells from growing too quickly.
BRCA1 and BRCA2 are examples of genes that help repair damaged DNA. When one of these genes has a harmful change, also called a mutation or pathogenic variant, it may not work as it should. This can allow abnormal cells to grow and may increase the risk of ovarian cancer, breast cancer, and other cancers.
Other inherited gene mutations can also increase ovarian cancer risk. These may include mutations in genes associated with Lynch syndrome and other hereditary cancer syndromes.
Learn more about inherited ovarian cancer risk and genetic testing.
Family cancer syndromes
A hereditary or family cancer syndrome occurs when a harmful genetic mutation is passed from a parent to a child. These mutations can increase the risk of certain cancers within a family.
Hereditary cancer syndromes connected to ovarian cancer include:
- Hereditary breast and ovarian cancer syndrome, often associated with BRCA1 or BRCA2 mutations
- Lynch syndrome
- Peutz-Jeghers syndrome
- MUTYH-associated polyposis
- Other less common inherited cancer syndromes
A family history of cancer does not always mean that a hereditary cancer syndrome is present. A genetic counselor can review your personal and family history and help determine whether genetic testing may be appropriate.
Fertility treatment
Research has not found clear evidence that fertility medications increase the risk of invasive ovarian cancer overall.
Some studies have suggested a possible increase in borderline ovarian tumors, sometimes called tumors of low malignant potential. However, it can be difficult to separate the effects of fertility treatment from the underlying causes of infertility or from never becoming pregnant.
If you are using or considering fertility medication, talk with your health care provider about your personal medical history and any concerns about cancer risk.
Smoking
Smoking has been linked to an increased risk of mucinous ovarian cancer, a less common type of ovarian cancer.
The relationship between smoking and other types of ovarian cancer is less clear. Quitting smoking can reduce the risk of several cancers and provide many other health benefits.
What does research say about talcum powder and ovarian cancer?
Research examining talcum powder and ovarian cancer has produced mixed results.
Some studies have reported a possible association between the use of talcum powder in the genital area and ovarian cancer, while other studies have not found a clear increase in risk. Researchers have also noted limitations in how talc exposure was reported and measured in earlier studies.
Because the evidence is not conclusive, talcum powder is not included in the primary list of established ovarian cancer risk factors on this page. The National Cancer Institute’s ovarian cancer prevention summary provides more information about the available research.
People who are concerned about past talc exposure should discuss those concerns with a health care provider.
💡 Prepare for a conversation about your ovarian cancer risk
Your health history and family history can help your health care provider better understand your individual risk. Download our Questions to Ask Your Doctor: Ovarian Cancer Risk worksheet to help guide your appointment and record important information about risk factors, genetic testing, screening, and ways to manage your risk.
Download the Ovarian Cancer Risk Questions Guide
Can ovarian cancer be prevented?
There is no known way to prevent every case of ovarian cancer. However, certain reproductive, medical, and surgical factors have been associated with a lower risk.
A lower risk does not mean that ovarian cancer cannot occur. Decisions about medications or surgery should always be based on your individual health history and discussed with a qualified health care provider.
Birth control
Oral contraceptives, commonly called birth control pills, are associated with a lower risk of ovarian cancer. The amount of risk reduction generally increases the longer birth control pills are used, and some protection may continue after a person stops taking them.
Birth control pills also have potential risks and side effects. They should not be taken solely to reduce ovarian cancer risk without first discussing the benefits and risks with a health care provider.
The American Cancer Society provides additional information about factors that may increase or lower ovarian cancer risk.
Childbirth and breastfeeding
Having one or more full-term pregnancies is associated with a lower risk of ovarian cancer. Breastfeeding may reduce the risk further, particularly when a person breastfeeds for a longer total amount of time.
Researchers believe this may be partly because pregnancy and breastfeeding reduce the total number of times a person ovulates during their lifetime.
Surgical options that may reduce ovarian cancer risk
Certain surgeries involving the fallopian tubes or ovaries may lower the risk of ovarian cancer. However, the type of surgery that may be appropriate depends on whether a person has an average or increased risk.
For people at average risk: Removal of the fallopian tubes
A salpingectomy is surgery to remove one or both fallopian tubes. When the fallopian tubes are removed during another planned surgery to help lower ovarian cancer risk, the procedure is called an opportunistic salpingectomy.
Research suggests that removing both fallopian tubes can reduce ovarian cancer risk by as much as 80%. This approach is based on growing evidence that many high-grade serous ovarian cancers, the most common type of ovarian cancer, begin in the fallopian tubes rather than the ovaries.
For people who have completed childbearing, removal of the fallopian tubes may be discussed when another pelvic surgery is already planned or as an alternative to tubal ligation for permanent birth control.
Removing the fallopian tubes lowers risk but does not eliminate the possibility of developing ovarian cancer.
The American College of Obstetricians and Gynecologists provides clinical guidance about opportunistic salpingectomy and ovarian cancer risk reduction.
People considering this procedure should discuss its potential benefits, limitations, and effects on fertility with their health care provider.
For people at higher risk: Removal of the fallopian tubes and ovaries
For some people at higher risk of ovarian cancer, surgery to remove both the fallopian tubes and ovaries may be recommended.
When healthy ovaries and fallopian tubes are removed specifically to lower cancer risk, the procedure is called a risk-reducing salpingo-oophorectomy, or RRSO.
This surgery can significantly reduce the risk of ovarian, fallopian tube, and primary peritoneal cancers in people with certain inherited genetic mutations or hereditary cancer syndromes.
However, the surgery cannot completely eliminate the risk because primary peritoneal cancer can rarely develop after the ovaries and fallopian tubes have been removed.
Removing the ovaries before natural menopause also causes immediate menopause and can affect fertility, bone health, cardiovascular health, sexual health, and overall well-being. A cancer risk assessment and counseling are important before making this decision.
Options for people at higher risk of ovarian cancer
If you have an increased risk of developing ovarian cancer, talk with your health care provider or a genetic counselor about the options that may be appropriate for you.
Your plan may include the following:
Genetic counseling and testing
Genetic testing may be recommended if your personal or family history suggests that you could have an inherited mutation associated with ovarian cancer.
A genetic counselor can explain:
- Whether genetic testing may be appropriate
- Which type of genetic test may be most useful
- What the results could mean for you
- Whether family members should consider testing
- Which cancer screening or risk-reduction options may be available
💡 Prepare for a conversation about genetic testing
Genetic testing can help identify inherited gene changes that may affect your ovarian cancer risk, medical care, and family members. Download our printable Questions to Ask Your Doctor: Genetic Testing for an Inherited Mutation worksheet to help you discuss how testing works, what your results may mean, costs and insurance, privacy, genetic counseling, and possible next steps.
Download the Genetic Testing Questions Guide
An individualized risk assessment
Your health care provider may evaluate your risk based on factors such as:
- Your personal medical history
- The types of cancer found in your family
- The ages at which family members were diagnosed
- Whether a family member has a known genetic mutation
- Your reproductive history
- Your ancestry or family background
This information can help your health care team recommend an appropriate risk-management plan.
Ovarian cancer screening
There is currently no reliable screening test that has been shown to detect ovarian cancer early enough to improve long-term survival. The National Cancer Institute’s ovarian cancer screening guide explains which tests have been studied and their limitations.
A CA-125 blood test measures the level of a protein that may be elevated in some people with ovarian cancer. However, CA-125 can also be elevated because of noncancerous conditions, including endometriosis. Some people with ovarian cancer may also have a normal CA-125 level.
A transvaginal ultrasound uses sound waves to create images of the ovaries and other pelvic organs. It can identify some masses, but it cannot determine by itself whether a mass is cancerous.
CA-125 testing and transvaginal ultrasound are not considered effective general ovarian cancer screening tests. In certain situations, a health care provider may discuss these tests with someone at increased risk, but their limitations should be clearly explained.
Learn more about the tests that may be used when ovarian cancer is suspected on our ovarian cancer diagnosis page.
Because there is no reliable routine screening test, it is also important to know the signs and symptoms of ovarian cancer and talk with a health care provider about symptoms that are persistent or unusual for you.
Oral contraceptives
Birth control pills may lower ovarian cancer risk in both people at average risk and people with certain inherited genetic mutations.
However, oral contraceptives also have potential risks. The decision to use them should be based on your full medical history and discussed with your health care provider.
Risk-reducing surgery
People with certain inherited genetic mutations or hereditary cancer syndromes may consider surgery to remove the ovaries and fallopian tubes.
The appropriate timing depends on factors such as:
- The specific genetic mutation
- The level of cancer risk
- Age
- Personal and family cancer history
- Plans for pregnancy
- The potential effects of early menopause
Risk-reducing surgery should be discussed with specialists who understand hereditary ovarian cancer risk. The procedure is often performed by a gynecologic oncologist.
Learn more about ovarian cancer surgery and the role of a gynecologic oncologist.
Management of Lynch syndrome
People with Lynch syndrome have an increased risk of several cancers, including colorectal, endometrial, and ovarian cancers.
A health care provider or genetic counselor can recommend cancer screening and risk-reduction options based on the specific gene mutation, age, medical history, and family history.
Fertility and reproductive planning
Some ovarian cancer risk-reduction options can permanently affect fertility.
People who may want to become pregnant in the future should discuss fertility preservation and reproductive planning before undergoing risk-reducing surgery. A health care team may include a gynecologic oncologist, genetic counselor, and fertility specialist.
Learn more about fertility preservation and reproductive health.
Genetics and genetic counseling
Inherited genetic mutations are an important ovarian cancer risk factor. A mutation can be passed to a child by either parent.
BRCA1 and BRCA2 are two of the best-known genes associated with hereditary breast and ovarian cancer. Everyone has BRCA1 and BRCA2 genes. The increased cancer risk occurs when a person inherits a harmful mutation in one of these genes.
According to the National Cancer Institute’s BRCA gene fact sheet, about 39% to 58% of women who inherit a BRCA1 mutation and 13% to 29% of women who inherit a BRCA2 mutation will develop ovarian cancer during their lifetime. By comparison, the average lifetime risk of ovarian cancer in the general population is approximately 1%.
These estimates include ovarian, fallopian tube, and primary peritoneal cancers.
Not everyone who inherits a BRCA1, BRCA2, or other cancer-related gene mutation will develop cancer.
What does a genetic counselor do?
A genetic counselor is a health professional with specialized training in inherited medical conditions and genetic testing.
Before genetic testing, a genetic counselor can help you understand:
- The likelihood that cancer in your family may be hereditary
- The benefits and limitations of genetic testing
- The different types of genetic test results
- How the results may affect your medical care
- Whether your relatives may also be at risk
- How genetic information may affect your children or other family members
Genetic testing can identify mutations that may be passed to children. Men can also inherit mutations in the BRCA1 andBRCA2 genes and pass them to their children.
Who should consider genetic counseling?
You may benefit from genetic counseling if you have:
- A personal or family history of ovarian, fallopian tube, or primary peritoneal cancer
- A family history of breast cancer diagnosed at a younger age
- Multiple relatives with breast, ovarian, colorectal, pancreatic, or certain prostate cancers
- A male relative with breast cancer
- A relative with a known inherited cancer-related mutation
- A personal or family history that suggests Lynch syndrome or another hereditary cancer syndrome
- Ashkenazi Jewish ancestry or another ancestry associated with specific inherited mutations, particularly when combined with a personal or family history of cancer
These are examples, not a complete list. A health care provider or genetic counselor can evaluate your full personal and family history.
Are all genetic mutations inherited?
Not all genetic mutations are inherited from a parent.
Some mutations develop during a person’s lifetime and are found only within cancer cells. These are called acquired or somatic mutations. They cannot be passed from a parent to a child.
Biomarker testing of the tumor may identify mutations in genes such as BRCA1, BRCA2, TP53, PTEN, PALB2, and others. In some cases, additional blood or saliva testing may be recommended to determine whether a mutation was inherited or developed only within the tumor.
Learn more about the difference between inherited genetic testing and biomarker tumor testing in our guide to genetic and biomarker tumor testing in ovarian cancer.
For more information about genetic testing or help finding a health care professional trained in genetics, contact the National Cancer Institute’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
Understanding your ovarian cancer risk
Ovarian cancer risk is different for everyone. Having one or more risk factors does not mean that you will develop ovarian cancer, and some people who are diagnosed have no known risk factors.
Understanding your personal and family health history can help you have more informed conversations with your health care team about your individual risk.
Ask your health care provider to explain:
- Which ovarian cancer risk factors may apply to you
- Whether your family health history suggests an inherited cancer risk
- Whether genetic counseling or testing may be appropriate
- What ovarian cancer screening tests can and cannot tell you
- Whether there are steps that may help reduce your risk
- How risk-reducing medications or surgery could affect your overall health, fertility, or menopause
If you have a strong family history of ovarian, breast, colorectal, pancreatic, or other related cancers, consider asking whether a referral to a genetic counselor would be appropriate.
Explore additional NOCC information and resources:
Frequently asked questions about ovarian cancer risk factors
Yes.
Some people who develop ovarian cancer have no known risk factors. Risk factors can help estimate whether someone may have a higher chance of developing cancer, but they cannot predict who will or will not develop ovarian cancer.
Knowing your personal and family health history and recognizing possible symptoms remain important even if you do not have an identified risk factor.
No.
A family history of ovarian cancer can increase your risk, especially when a close relative has been diagnosed, but it does not mean that you will develop ovarian cancer.
Some families carry inherited genetic mutations that increase cancer risk, while others do not. A health care provider or genetic counselor can help evaluate your family history and determine whether genetic testing may be useful.
Yes.
BRCA1 and BRCA2 mutations can be inherited from either parent. Fathers and mothers can carry these mutations and pass them to their children.
Cancer history on both sides of your family should be considered when assessing hereditary cancer risk.
No.
Most people with endometriosis do not develop ovarian cancer. However, research has found that endometriosis is associated with a modestly increased risk of certain ovarian cancer subtypes, particularly clear cell and endometrioid ovarian cancers.
Talk with your health care provider about your individual medical history if you have concerns.
There is currently no ovarian cancer screening test that has been proven to detect the disease early enough to improve long-term survival.
CA-125 blood testing and transvaginal ultrasound may be discussed in certain situations for people at increased risk, but these tests have important limitations.
People at increased hereditary risk should discuss genetic counseling, risk-reducing options, and an individualized plan with their health care team.
Removing both fallopian tubes can significantly lower the risk of developing some ovarian cancers, but it does not eliminate the risk completely.
For people at average risk who have completed childbearing, removing the fallopian tubes may be considered during another planned pelvic surgery or instead of tubal ligation.
People with certain inherited genetic mutations may need a different risk-reduction strategy, including removal of both the fallopian tubes and ovaries.
Not always.
Most research about ovarian cancer risk factors and prevention focuses on epithelial ovarian cancers, which are the most common ovarian cancers.
Much less is known about the causes and risk factors for ovarian germ cell tumors and sex cord-stromal tumors.
Your individual risk assessment should consider your medical history, family history, genetic information, and other factors that may be relevant to you.
More information about ovarian cancer risk factors
