Ovarian Cancer Risk Factors & Screening Options

What are the risk factors for ovarian cancer?

Several factors can raise your risk of developing ovarian cancer. Your risk is higher if you:

• Are middle-aged or older
• Have close family members (on either your mother's or father's side) who've had ovarian cancer
• Have inherited mutations in specific genes, such as BRCA1 or BRCA2
• Are overweight or obese
• Have never been pregnant
• Have endometriosis
• Have Lynch syndrome, an inherited condition that increases the risk of several types of cancer

It's important to note that most ovarian cancers occur in people without known risk factors. Anyone with ovaries can develop ovarian cancer.

BRCA1 and BRCA2 gene mutations

BRCA1 and BRCA2 are genes that normally help prevent cells from growing and dividing too quickly. When a mutation is inherited in one of these genes, the cancer-preventing function is less effective. A mutation can be inherited from either parent.

About 50% of women with a BRCA1 mutation will develop breast or ovarian cancer by age 70. A BRCA2 mutation also raises ovarian cancer risk but not as much as BRCA1 does.

If you have a family history of breast or ovarian cancer, talk with your doctor about genetic counseling and testing.

Are there screening tests for ovarian cancer?

Screening tests are designed to detect cancer before symptoms appear. This allows doctors to find cancers in early stages, when they're typically easier to treat.

Unfortunately, there are no reliable screening tests for ovarian cancer at this time. However, if you're at high risk for ovarian cancer, your doctor may recommend one or both of the following:

• CA-125 blood test. This measures levels of CA-125, a protein that can be higher in ovarian cancer cells than in normal cells. Unfortunately, the test isn't very accurate – some women without ovarian cancer have high levels, and some with cancer don't.
• Transvaginal ultrasound. A small probe is inserted into the vagina to capture images of the ovaries.

These tests are not recommended for routine screening of people at average risk.

I'm at high risk for ovarian cancer. Can I lower my odds of getting it?

There are two measures you can consider taking to reduce your risk.

Birth control pills

For women at high risk, taking oral contraceptives (birth control pills) may cut ovarian cancer risk by up to 50%. However, for those with a BRCA1 or BRCA2 mutation, birth control pills may increase breast cancer risk. Additional research is needed to understand the benefits and risks for this group.

Preventive surgery

Some high-risk women choose to have both ovaries surgically removed in a procedure called prophylactic oophorectomy. This surgery significantly reduces the risk of ovarian cancer.

If you're still menstruating, a prophylactic oophorectomy would cause premature menopause. For this reason, it's generally recommended only if you don't want to have children in the future.

Patients who undergo prophylactic oophorectomy can still develop peritoneal cancer, a rare cancer of the tissue lining the abdomen. Peritoneal cancer behaves similarly to ovarian cancer.