Our cancer specialists at Penn Medicine's Abramson Cancer Center believe that knowing the risks for ovarian cancer is one of the best ways to maintain gynecologic health.
How you understand and translate health risks impacts your decision-making when it comes to treatment options. Genetic testing and counseling for ovarian cancer and breast cancer risk factors offer many benefits, including implementing preventative treatment options and/or lifestyle changes that can reduce the risk of having cancer.
The Mariann and Robert MacDonald Cancer Risk Evaluation Center helps women and their families assess their risks for breast and ovarian cancer.
Ovarian Cancer Risk Factors
While all women are at risk for ovarian cancer, some factors can increase your risk:
- Genetic predisposition. BRCA1 and BRCA2 are two genes found to increase risk for breast and ovarian cancer.
- History. Personal or family history of breast, ovarian or colon cancer.
- Undesired infertility/childbearing. Women who have never had children are more likely to develop ovarian cancer than women who have had children. In fact, the more children a woman has had, the less likely she is to develop ovarian cancer.
- Increasing age. The likelihood of developing ovarian cancer increases as women get older.
- Hormone replacement therapy (HRT). Some evidence suggests that women who use HRT after menopause may have a slightly increased risk of developing ovarian cancer.
- Having excess body fat. Having excess body fat as measured by body mass index (BMI), including during the teen years, increases the risk of ovarian cancer. Diet and nutrition during the teen years may play a role in prevention.
If you have one or more of these factors, it does not mean that you will get ovarian cancer.
Ovarian Cancer Risk Assessment
At Penn Medicine's Abramson Cancer Center, we are national leaders in the field of breast and ovarian cancer genetics. We were the first in the country to establish a Breast and Ovarian Cancer Risk Evaluation Program. If you are concerned about the risk of breast and/or ovarian cancer, it's important to have the best team of experts.
The Mariann and Robert Macdonald Cancer Risk Evaluation Center is nationally recognized for breast and ovarian cancer risk assessment. They can provide the information, care and support to help each step of the way.
Ovarian Cancer Prevention
Cancer specialists at Penn Medicine suggest several ways women can reduce their risk of developing ovarian cancer, including:
- Using oral contraceptives. Birth control pills decrease the risk of developing ovarian cancer, especially among women who use them for several years. Women who used oral contraceptives for five or more years have about a 50 percent lower risk of developing ovarian cancer compared with women who never used oral contraceptives.
- Gynecologic surgery. Both tubal ligation and hysterectomy may reduce the chance of developing ovarian cancer, but experts agree that these operations should only be done for valid medical reasons and not for their effect on ovarian cancer risk. Women with a strong family history of ovarian or breast cancer who are having a hysterectomy for a valid medical reason may wish to consider having both ovaries removed (bilateral oophorectomy) as part of that procedure. Menopausal women scheduled for hysterectomy should discuss the benefits of having both ovaries removed with their doctor.
Strategies for Women at Higher Risk for Ovarian Cancer
If you have a family history of ovarian cancer or carry the BRCA gene mutation, you can work with your Penn Medicine physician to develop a prevention strategy.
Genetic counseling can predict the likelihood of having one of the gene mutations associated with an increased ovarian cancer risk. If you have a family history that suggests you might have one of these gene mutations, you might consider genetic testing. Genetic tests have benefits and drawbacks, so the decision to undergo testing should include discussions with family, physicians and genetic counselors.
For some women with a strong family history of ovarian cancer, knowing they do not have a mutation that increases their ovarian cancer risk can be a great relief for them and their children. For those who learn they do carry a mutation, the information can be stressful as well as helpful in making important decisions about certain prevention strategies for them and their children.
Oral Contraceptive Use
Oral contraceptives also seem to reduce the risk for women with BRCA1 and BRCA2 mutations, but may increase the risk of breast cancer. Research is continuing to find out more about the risks and benefits of oral contraceptives for women at high ovarian and breast cancer risk.
It is not clear if tubal ligation is effective in reducing the risk of ovarian cancer in women who have the BRCA1 or BRCA2 mutations, but ovary and fallopian tube removal (salpingo-oophorectomy) protects women with BRCA1 or BRCA2 mutations against ovarian and fallopian tube cancer.
For some women at extremely high risk for ovarian cancer, prophylactic surgery to remove the ovaries before cancer is diagnosed may be recommended, as long as they are finished having children. The surgery reduces, but does not entirely eliminate, the risk of ovarian cancer. In rare cases, small ovarian tumors are found during prophylactic surgery. Women with BRCA1/BRCA2 gene mutations also have an increased risk of primary peritoneal carcinoma (PPC) that can still develop after the ovaries are removed. The risk of fallopian tube cancer is also increased in women with mutations in BRCA1 or BRCA2, so experts recommend that women at high risk of ovarian cancer who are having their ovaries removed have their fallopian tubes completely removed as well.
Research has shown that premenopausal women with BRCA gene mutations who have had their ovaries removed, reduce their risk of breast cancer as well as their risk of ovarian cancer. The risk of ovarian cancer is reduced by 85 to 95 percent, and the risk of breast cancer by 50 to 60 percent.