Risk Factors for Ovarian Cancer

This is the third article in the Understanding Ovarian Cancer Guide. This guide was developed by the HealthTree Education Team and was last updated and reviewed on May 20, 2026. 

Anything that increases your chance of developing cancer is called a risk factor. Sometimes, risk factors directly cause cancer. For example, UV radiation from the sun directly damages the DNA in ovarian cells. Most often, though, risk factors do not directly cause cancer on their own. Instead, many small changes over time lead to the genetic changes that cause cancer.

It is important to remember that having one or more risk factors for ovarian cancer does not guarantee you will develop ovarian cancer. It is also possible to develop ovarian cancer even if you do not have any known risk factors. Researchers are still learning how ovarian cancer develops.

What raises your risk for developing ovarian cancer?

• Age. Ovarian cancer is most frequently diagnosed among women aged 55–64.
• Family history of ovarian or breast cancer. Having a first-degree relative (parent, sibling, or child) with ovarian cancer increases your risk. A strong family history of breast cancer, especially at younger ages, also raises risk because of shared genetic factors.
• Inherited gene mutations. Several inherited gene mutations significantly increase ovarian cancer risk:
  • BRCA1 mutations: lifetime ovarian cancer risk of approximately 39–46%
  • BRCA2 mutations: lifetime ovarian cancer risk of approximately 10–27%
  • Lynch syndrome (mutations in MLH1, MSH2, MSH6, PMS2): lifetime ovarian cancer risk of approximately 6–20%
  • Other genes including RAD51C, RAD51D, BRIP1, and PALB2 are also linked to increased ovarian cancer risk
• Personal history of breast cancer. Having had breast cancer, particularly at a younger age or with a BRCA mutation, increases the risk of ovarian cancer.
• Endometriosis. A condition where uterine-like tissue grows outside the uterus. It is associated with an increased risk of clear cell and endometrioid ovarian cancer subtypes.
• Reproductive history. Never having been pregnant, having a first pregnancy after age 35, or starting menstrual periods at an early age and reaching menopause at a later age are associated with a modestly increased risk.
• Hormone replacement therapy (HRT). Long-term use of estrogen-only hormone replacement therapy after menopause has been associated with an increased risk of ovarian cancer. The risk associated with combination HRT (estrogen plus progestin) is less clear.
• Obesity. Being overweight or obese has been linked to a modestly higher risk of ovarian cancer.
• Fertility treatments. The relationship between fertility drugs and ovarian cancer is complex. Most research has not shown a clear increased risk, but some studies suggest a small association in certain situations. Talk with your doctor if you have concerns.
• Race and ethnicity. Ovarian cancer is more common in white women than in Black, Hispanic, or Asian women. People of Ashkenazi Jewish descent have a higher rate of BRCA mutations and a corresponding higher risk of ovarian cancer.

Factors that may lower your risk

Some factors are associated with a lower risk of ovarian cancer:

• Pregnancy and breastfeeding
• Use of oral contraceptives (birth control pills), particularly with longer duration of use
• Tubal ligation (“having your tubes tied”)
• Removal of the fallopian tubes (salpingectomy), often considered at the time of other pelvic surgery
• Hysterectomy