How is ovarian cancer prevented?

Updated: Aug 10, 2020
  • Author: Andrew E Green, MD; Chief Editor: Yukio Sonoda, MD  more...
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Answer

The risk of developing epithelial ovarian cancer (EOC) is significantly reduced by the following:

  • Bearing children
  • Using the combined oral contraceptive pill
  • Undergoing tubal ligation
  • Undergoing bilateral oophorectomy

Evidence suggests that taking oral contraception for at least 5 years reduces the relative risk of developing EOC to 50% of the risk for a woman who has never taken it.

Prophylactic bilateral salpingo-oophorectomy is indicated in high-risk women. [118] The American College of Obstetricians and Gynecologists recommends offering bilateral salpingo-oophorectomy to women with BRCA1 or BRCA2 mutations after completion of childbearing (level B recommendation). [119]  On the basis of their study in 5,783 women with a BRCA1 or BRCA2 mutation, Kinch et al concluded that in BRCA1 mutation carriers, oophorectomy at age 35 years can be recommended. [120]

Surgical prophylaxis decreases the risk by at least 80%. [120] Salpingo-oophorectomy does not prevent all cases of related cancer, as women are still at risk for developing primary peritoneal carcinomas.The epithelial lining of the ovaries is embryologically identical with the lining of the peritoneal cavity, and similar cancers can develop from the peritoneum. Thus, while oophorectomy prevents a pure EOC from developing, a small risk still exists for developing carcinoma of the peritoneum, a disease that behaves similarly to EOC.

BRCA1 and BRCA2 mutations are common among women with invasive ovarian cancer; thus, women diagnosed with invasive, nonmucinous ovarian cancer are candidates for genetic testing. [121]

For women with BRCA1 and BRCA2 mutations who opt to not undergo early oophorectomy, the task force of the Cancer Genetics Studies Consortium recommends transvaginal ultrasound, timed to avoid the middle of the menstrual cycle, together with serum CA125 levels performed every 6-12 months in women aged 25-35 years. Use of the oral contraceptive pill is associated with lower risk of EOC in these women. [122]


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