Ovarian Cancer Prevention

There is no guaranteed way to prevent ovarian cancer. Some of the most important risk factors, including age, family history, and inherited genetic changes, cannot be changed. However, certain factors are associated with a lower risk of ovarian cancer. For people at increased genetic or familial risk, there are also medical and surgical options that can significantly reduce risk. Understanding your personal risk is an important first step in deciding whether you may benefit from genetic counseling, testing, or other risk-reducing strategies.

Know your ovarian cancer risk

Anyone with ovaries can develop ovarian cancer, but certain factors can increase your risk. These include:

• Older age, particularly after menopause

• A family history of ovarian cancer

• A personal or family history of breast cancer

• Inherited genetic changes, particularly in BRCA1 or BRCA2

• Lynch syndrome

• Certain other inherited cancer syndromes

• Endometriosis

• Never having been pregnant

• Having a first full-term pregnancy later in life

Having one or more risk factors does not mean that you will develop ovarian cancer. Many people diagnosed with ovarian cancer do not have a known inherited genetic risk.

Understand your family history

Family history can provide important clues about your ovarian cancer risk. Tell your healthcare provider if close relatives have been diagnosed with:

• Ovarian cancer

• Fallopian tube cancer

• Primary peritoneal cancer

• Breast cancer, particularly at a young age

• Pancreatic cancer

• Prostate cancer

• Colorectal or endometrial cancer

Cancer on both your mother's and father's sides of the family matters. Depending on your family history, your healthcare provider may recommend genetic counseling or testing.

Consider genetic counseling and testing

Some ovarian cancers are associated with inherited genetic changes passed from a parent to a child. The best-known are harmful variants in the BRCA1 and BRCA2 genes, but other genes can also increase ovarian cancer risk. Lynch syndrome, which is caused by inherited changes in certain DNA repair genes, is also associated with an increased risk. Genetic counseling can help you understand:

• Your personal and family cancer history

• Whether genetic testing may be appropriate

• What different test results could mean

• How a genetic result might affect your screening or prevention options

• What the results could mean for your relatives

If you are found to have an inherited genetic change associated with ovarian cancer, your healthcare team can develop a personalized risk-reduction plan.

Birth control pills and ovarian cancer risk

Using oral contraceptives, commonly called birth control pills, is associated with a lower risk of ovarian cancer. The reduction in risk generally becomes greater with longer use and may continue for years after a person stops taking them. However, birth control pills have their own potential risks and benefits and should not be taken solely for ovarian cancer prevention without discussing your individual health history with a healthcare provider.

Pregnancy and breastfeeding

Pregnancy and breastfeeding are both associated with a lower risk of ovarian cancer. Researchers believe this may be partly because these experiences reduce the number of times a person ovulates during their lifetime. These are associations rather than recommendations to become pregnant or breastfeed specifically to prevent cancer.

Risk-reducing surgery

For people with a very high inherited risk of ovarian cancer, surgery can substantially reduce the chance of developing the disease. The most common procedure is a risk-reducing salpingo-oophorectomy, which removes both fallopian tubes and ovaries. This may be recommended for some people with BRCA1, BRCA2, or certain other inherited genetic changes after they have completed childbearing. The recommended timing depends on the specific gene, age, family history, and personal preferences. Removing the ovaries causes menopause if it has not already occurred, so the benefits and potential long-term effects should be discussed carefully with your healthcare team.

The role of the fallopian tubes

Research has shown that many cancers historically classified as ovarian cancer, particularly high-grade serous cancers, may actually begin in the fallopian tubes. Because of this, opportunistic salpingectomy may be discussed with some people who are already planning pelvic surgery and have completed childbearing. This involves removing the fallopian tubes while leaving the ovaries in place. This approach may reduce ovarian cancer risk while avoiding the immediate menopause caused by removing the ovaries. However, it does not eliminate ovarian cancer risk and is not necessarily an alternative to removing both the ovaries and fallopian tubes for people at very high inherited risk.

Can lifestyle changes prevent ovarian cancer?

Unlike several other cancers, there are no specific diet, exercise, or lifestyle changes proven to prevent ovarian cancer. Maintaining a healthy weight, staying physically active, avoiding tobacco, and eating a balanced diet are important for overall health and may reduce the risk of several cancers and other chronic diseases. However, these habits should not be considered a substitute for genetic counseling or other risk-reducing strategies if you have an increased hereditary risk of ovarian cancer.

The bottom line

There is no guaranteed way to prevent ovarian cancer, but understanding your individual risk can help you make informed decisions about prevention. If ovarian, breast, pancreatic, prostate, colorectal, or endometrial cancers run in your family, ask your healthcare provider whether genetic counseling or testing may be appropriate.

For people with certain inherited genetic changes, risk-reducing surgery can significantly lower the chance of developing ovarian cancer. Your healthcare team can help you determine which prevention strategies, if any, are appropriate for you.