Ovarian cancer risk factors

Anyone born with ovaries can develop ovarian cancer, but risk is not the same for everyone. Knowing which factors apply to you won’t tell you whether you will or won’t get this disease — most women with risk factors never develop it, and some with none do. What it can do is help you and your doctor decide whether genetic counseling, closer monitoring, or preventive steps make sense for you.

What raises risk

Getting older. Risk rises with age. Most ovarian cancers develop after menopause, and the majority are diagnosed at age 55 or older. A diagnosis before 40 is possible, but rare.

A family history of certain cancers. A family history of ovarian, breast, or colorectal cancer raises your risk, because some inherited gene mutations can drive all three. This is one of the strongest reasons to consider genetic counseling.

Inherited BRCA mutations. Changes in the BRCA1 or BRCA2 genes keep them from doing their normal job of controlling cell growth. Women with a BRCA1 mutation have roughly a 35–70% lifetime risk of ovarian cancer; with BRCA2, roughly 10–30%. For women without either mutation, lifetime risk is under 2%.

Family cancer syndromes. Inherited conditions such as Lynch syndrome, Peutz-Jeghers syndrome, and MUTYH-associated polyposis also raise ovarian cancer risk.

A personal history of breast cancer. If you’ve had breast cancer, your risk of ovarian cancer is higher — the two diseases share reproductive and genetic risk factors.

Reproductive history. Having your first full-term pregnancy after age 35, or never carrying a pregnancy to term, is associated with higher risk.

Hormone replacement therapy. Using hormone therapy for perimenopause or menopause symptoms appears to slightly increase risk.

Excess weight. A body mass index of 30 or higher can increase the risk of developing ovarian cancer.

Fertility treatment. In vitro fertilization (IVF) may raise the risk of the “borderline” (low malignant potential) type of ovarian tumor.

Smoking. Smoking’s overall effect on ovarian cancer is unclear, but it has been linked to the mucinous subtype, which accounts for a small share of cases.

What about talcum powder?

You may have seen headlines linking talcum powder to ovarian cancer. Numerous scientific studies have consistently found no conclusive evidence that using talc raises ovarian cancer risk.

What lowers risk

• Birth control pills. Oral contraceptives can reduce ovarian cancer risk by 30–50%, and the protection lasts longer the longer they’re used.
• Pregnancy and breastfeeding. A full-term pregnancy before age 26 lowers risk, each additional pregnancy lowers it a bit more, and breastfeeding adds further protection.
• Surgery. Tubal ligation and hysterectomy reduce risk, though they’re only recommended when there’s a valid medical reason. Some surgeons now offer opportunistic salpingectomy — removing the fallopian tubes during another planned abdominal surgery. For women at high inherited risk, removing the ovaries and fallopian tubes (risk-reducing salpingo-oophorectomy) is an option worth discussing with a specialist.

If your risk is higher than average

There is still no reliable screening test for ovarian cancer in average-risk women, but if you carry a known mutation or have a strong family history, your care team may recommend:

• Genetic counseling and testing — especially if ovarian, breast, or colorectal cancer runs in your family, or if you’re of Ashkenazi Jewish descent with a family history. A genetic counselor helps you understand your results and your options.
• CA125 blood tests — useful for monitoring, though the test has real limitations. Read our guide to what CA125 can and can’t tell you.
• Transvaginal ultrasound — often offered every six months for high-risk women.
• For Lynch syndrome — periodic mammography, colonoscopy, and endometrial biopsy may also be recommended.

Not every concerning mutation is inherited — some, like changes in TP53, PTEN, or PALB2, can develop over a lifetime. If anything on this page sounds like your family’s story, bring it up with your doctor. That one conversation is how most high-risk women find out in time to act.