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Ovarian cancer develops when genetic mutations (variations) cause abnormal cell growth in the ovaries, leading to tumors. Tumors that form in the fallopian tubes or the peritoneum (the lining of the abdomen) are often grouped with ovarian cancer because they have similar causes, symptoms, and treatments. Although some factors can raise your risk, it’s important to remember that many people who have several risk factors never develop ovarian cancer.
Ovarian cancer can be caused by two main types of mutations: inherited and acquired. Most cases are caused by acquired genetic changes.
Inherited mutations are:
Acquired mutations:
Inherited mutations that run in families are involved in up to 25 percent of ovarian cancer cases. DNA sequencing tests can help show whether a mutation is inherited or acquired. However, in most cases, the exact cause of ovarian cancer is unknown.
Normal cells divide regularly to replace old or damaged cells. Certain genes control this process by telling cells when to divide and when to stop dividing. Other genes work like a quality control system — they identify and fix DNA mistakes or tell damaged cells to self-destruct so they don’t keep multiplying.
When a genetic mutation turns off one or more of these protective genes, the system breaks down. Cells may start dividing too quickly or in an uncontrolled way. Over time, more mutations can build up, making the cells even more abnormal.
When these abnormal cells begin invading nearby tissues, they are considered cancerous.
Scientists have identified many factors that appear to be linked with ovarian cancer risk. However, just because two things are linked doesn’t mean one directly causes the other. Some risk factors for ovarian cancer are still being studied to understand their role in the development of the disease.
Since genetic mutations cause ovarian cancer, risk factors for ovarian cancer include anything that can encourage mutations. The average woman in the U.S. has about a 1.1 percent chance of developing ovarian cancer at some point. Mutations inherited from one’s parents and mutations acquired over time due to age or environmental or lifestyle factors may raise or lower this risk.
Having a family history of ovarian cancer increases your personal risk. When a particular gene mutation that is strongly linked to cancer is passed down within a family, this is called a family cancer syndrome.
One example is hereditary breast and ovarian cancer (HBOC). This condition is a family cancer syndrome that can lead to ovarian or breast cancer, as well as other cancers such as pancreatic cancer. People with HBOC tend to develop cancer at a younger age or get cancer multiple times. In hereditary ovarian cancer, about 65 percent to 85 percent of cases are linked to mutations in the BRCA1 or BRCA2 gene.
The BRCA genes act as “tumor suppressor” genes. They help repair DNA damage and prevent cells from turning abnormal. When someone inherits a BRCA gene mutation, damage can pile up in the cell, leading to additional acquired mutations that cause cancer. Having a BRCA1 and BRCA2 gene mutation raises risk, but not every person with these mutations will get cancer. Women with a BRCA1 mutation have a 40 percent to 60 percent chance of developing ovarian cancer, while those with a BRCA2 mutation have a 20 percent to 35 percent chance, according to MedlinePlus.
Other family cancer syndromes associated with ovarian cancer are caused by different gene mutations. For example, Lynch syndrome is caused by mutations in the repair genes MLH1, MSH2, and MSH6. Lynch syndrome increases a person’s risk of colon, ovarian, stomach, pancreas, kidney, and brain cancers.
Cancer may also run in families, but no known gene mutation has been found. If ovarian cancer runs in your family, genetic testing may help you learn about your risk.
Researchers have found several environmental factors linked to ovarian cancer, including smoking, viral infections, and exposure to pesticides. Some risks can be avoided, but others can’t. Anything that increases the chance of acquired gene mutations also increases the risk of ovarian cancer.
Mutations in DNA are inevitable. The older you get, the more acquired mutations you will have. However, cancer caused by aging only develops in a small percentage of people.
Ovarian cancer risk increases with age. While a few types of ovarian cancer are found in younger women, most cases occur during middle age or later. Half of ovarian cancer diagnoses are made after age 63.
There’s a link between ovulation (the release of an egg from an ovary) and the risk of ovarian cancer. Researchers think this may be because the more someone is exposed to estrogen — a reproductive hormone mainly produced by the ovaries — the more likely they are to get cancer. This means that the more you ovulate, the higher your risk of ovarian cancer. Factors that reduce or stop ovulation can help lower that risk.
Factors that increase the number of ovulations or estrogen levels and raise ovarian cancer risk include:
On the other hand, those who’ve had fewer ovulations have a lower chance of developing ovarian cancer. Hormone-related factors that reduce risk include:
Some surgeries can also change a person’s risk. Tubal ligation (also called “getting your tubes tied”) can lower the risk of ovarian cancer by 67 percent. Having a hysterectomy (surgery to remove all or parts of the uterus) can lower the risk by 33 percent.
Very high doses of radiation may increase the chance of ovarian cancer. For example, nuclear workers or people exposed to atomic bombs have a higher risk. However, low doses of radiation do not appear to increase the risk.
Smoking cigarettes increases the risk of mucinous ovarian cancer, but it may not raise the risk for other types of ovarian cancer. People who smoke also tend to have worse outcomes if they are diagnosed with ovarian cancer.
Some research suggests that eating high amounts of animal fats may raise the risk of ovarian cancer. Animal fats are found in foods like red meat and dairy products (such as milk, butter, and cheese).
Being overweight is linked to several types of cancer. Researchers aren’t completely sure how it affects ovarian cancer risk yet, but some studies show that people with obesity (a body mass index score of 30 or higher) may be more likely to develop ovarian cancer, especially after menopause.
A person’s risk of ovarian cancer may also be higher if they have had another health condition or another type of cancer. People who have had breast, uterine, rectal, or colon cancer may have an increased risk of ovarian cancer. Having endometriosis can raise the risk of endometrial or clear cell ovarian cancer.
Rates of ovarian cancer are different among racial and ethnic groups. According to a 2017 review of 19 past studies, non-Hispanic white women in the U.S. have the highest rates of epithelial ovarian cancer (the most common type). They are followed by Hispanic, Asian/Pacific Islander, and Black women. These differences are likely due to a mix of reproductive, hormonal, and lifestyle risk factors.
Unfortunately, there’s no guaranteed way to prevent cancer. Some people have many risk factors and never get the disease, while others who are diagnosed don’t seem to have any risk factors at all. If you’re concerned about your risk of ovarian cancer, focus on lowering the risks that are within your control, such as certain lifestyle or environmental factors.
If you think you may be at an increased risk, watch out for some of the symptoms of ovarian cancer, such as bloating, abdominal pain, or frequent urination. If you notice these changes or have concerns, talk to your doctor to learn more about your ovarian cancer risk.
On MyOvarianCancerTeam, people share their experiences with ovarian cancer, get advice, and find support from others who understand.
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