Ovarian Cancer Series 04: Can Ovarian Cancer Be Prevented? How to Reduce the Risk
After learning about the risk factors for ovarian cancer, a natural question often follows:
“Can ovarian cancer be prevented?”
At present, there is no proven way to prevent all ovarian cancers that applies to every woman. But that does not mean there is nothing that can be done to reduce risk.
Some reproductive and hormonal factors are associated with a lower risk of ovarian cancer. In certain situations, removal of the fallopian tubes may also be discussed as a risk-reducing strategy. For women with a high inherited risk, such as those with pathogenic BRCA1 or BRCA2 variants, more active risk-reduction strategies may be considered.
The first important distinction is that preventing ovarian cancer completely is not the same as reducing the chance that it will develop.
Is There a Proven Way to Prevent Ovarian Cancer?
There is currently no single method that can prevent all ovarian cancers.
Ovarian cancer does not develop from one cause alone. Age, inherited genetic factors, family history, and reproductive and hormonal factors can all influence risk.
For this reason, it would be inaccurate to suggest that a particular food, supplement, or exercise program can prevent ovarian cancer.
When discussing ovarian cancer, risk reduction is often a more useful concept than complete prevention.
A particular factor or medical intervention may lower the likelihood of developing ovarian cancer, but it cannot guarantee that the disease will never occur.
The practical starting point, therefore, is to understand your individual level of risk and determine whether any risk-reducing strategies may be appropriate.
Which Factors Are Associated With a Lower Risk of Ovarian Cancer?
Research has found that several reproductive and hormonal factors, including having given birth, breastfeeding, and oral contraceptive use, are associated with a lower risk of ovarian cancer.
However, these associations should not automatically be interpreted as actions that women should take specifically to prevent ovarian cancer.
For example, the association between having given birth and lower ovarian cancer risk does not mean that someone should have children for cancer prevention. Decisions about pregnancy and childbirth involve personal health, family planning, and many other considerations.
It is more appropriate to understand these as protective factors associated with ovarian cancer risk, rather than as a checklist of preventive actions.
One factor that receives particular attention is the use of oral contraceptives.
Can Birth Control Pills Reduce Ovarian Cancer Risk?
Oral contraceptives are among the factors with relatively consistent evidence of an association with reduced ovarian cancer risk.
According to the U.S. National Cancer Institute (NCI), women who have ever used oral contraceptives have been observed to have about a 30% to 50% lower risk of ovarian cancer than women who have never used them.
In general, greater risk reduction has been observed with longer use, and the lower risk may persist for many years after oral contraceptive use is discontinued. A reduction in ovarian cancer risk has also been observed among women with pathogenic BRCA1 or BRCA2 variants who have used oral contraceptives.
However, these findings should not be interpreted to mean that every woman should take birth control pills specifically to prevent ovarian cancer.
Oral contraceptives have benefits as well as potential risks that vary according to an individual’s health and circumstances. The decision to use them should therefore take into account overall health, contraceptive needs, and other relevant factors rather than ovarian cancer risk alone.
Oral contraceptive use is associated with a reduced risk of ovarian cancer, but it is not a universal ovarian cancer prevention strategy.
Can a Healthy Lifestyle Prevent Ovarian Cancer?
Healthy eating and regular physical activity are important for overall health.
However, there is currently no specific diet, food, supplement, or lifestyle practice proven to prevent ovarian cancer.
Claims that a particular food can prevent ovarian cancer or that a certain supplement can eliminate ovarian cancer risk should therefore be viewed cautiously.
This does not mean that healthy lifestyle habits are unimportant.
A balanced diet, regular physical activity, and maintaining a healthy weight remain important components of general health. They simply should not be presented as proven ovarian cancer-specific prevention methods.
For women with a strong family history or inherited genetic risk, healthy lifestyle habits also cannot replace appropriate risk assessment or medical risk-reduction strategies when those strategies are indicated.
Can Removing the Fallopian Tubes Reduce Ovarian Cancer Risk?
Ovarian cancer was once thought to begin primarily in the ovaries.
Today, evidence indicates that a substantial proportion of high-grade serous carcinoma, a common and aggressive type of epithelial ovarian cancer, may originate in the fallopian tubes.
This understanding has influenced strategies designed to reduce ovarian cancer risk.
For example, when a woman at average risk is already undergoing hysterectomy or another pelvic operation for a medical reason, removal of the fallopian tubes at the same time may be discussed as a strategy to reduce future ovarian cancer risk. This approach is known as opportunistic salpingectomy.
This does not mean that every woman should undergo surgery solely to prevent ovarian cancer.
The reason for the original surgery, age, future pregnancy plans, and individual health circumstances should all be considered. Removing the fallopian tubes also does not eliminate the risk of ovarian or related peritoneal cancers completely.
It is particularly important to distinguish this approach from risk-reducing surgery used for women with inherited high-risk genetic variants.
Opportunistic removal of the fallopian tubes in an average-risk woman and removal of both the fallopian tubes and ovaries in a genetically high-risk woman are different strategies used in different circumstances.
How Does Risk Reduction Change for Women With BRCA Variants?
When a high inherited risk, such as a pathogenic BRCA1 or BRCA2 variant, has been identified, the central question changes.
It is no longer simply:
“How high is my risk?”
The next question becomes:
“What can be done to reduce that risk?”
For women at high inherited risk, risk-reduction planning may take into account the specific genetic variant, age, family history, and reproductive plans.
Depending on the individual situation, discussions may include the benefits and risks of oral contraceptives and, at an appropriate time, risk-reducing surgery.
An important distinction is that opportunistic salpingectomy in women at average risk is not the same as the established risk-reducing surgical approach used for women with pathogenic BRCA1 or BRCA2 variants.
Removing the fallopian tubes first and delaying removal of the ovaries is also being studied in women at high inherited risk. However, this approach should not currently be considered an established replacement for standard risk-reducing salpingo-oophorectomy (RRSO).
For this reason, women with an identified inherited high risk should make these decisions through genetic counseling and specialist medical care rather than choosing a risk-reduction strategy on their own.
Who May Consider Risk-Reducing Salpingo-Oophorectomy?
One of the most important strategies considered for women at high risk of ovarian cancer, including those with pathogenic BRCA1 or BRCA2 variants, is risk-reducing salpingo-oophorectomy (RRSO).
This operation removes both the fallopian tubes and ovaries to substantially reduce the risk of ovarian and fallopian tube cancers.
Studies involving women with pathogenic BRCA1 or BRCA2 variants have found RRSO to be associated with an approximately 90% reduction in ovarian cancer risk.
However, the risk does not fall to zero.
A small risk of primary peritoneal cancer remains even after the fallopian tubes and ovaries have been removed. RRSO is therefore more accurately described as surgery that substantially reduces cancer risk rather than surgery that guarantees complete prevention.
RRSO is also not a simple decision based only on its cancer risk-reduction benefit.
When both ovaries are removed before natural menopause, the sudden decrease in ovarian hormones causes surgical menopause. This may lead to symptoms such as hot flashes and vaginal dryness, while longer-term bone and cardiovascular health may also need to be considered.
After both ovaries are removed, natural conception using a woman’s own eggs is no longer possible, making future fertility plans another important part of the decision.
The appropriate timing of RRSO is therefore not the same for every woman. The specific genetic variant, age, family history, individual cancer risk, and reproductive plans all need to be considered with the medical team.
RRSO can be a highly important risk-reduction strategy for women at high inherited risk, but its benefits should be considered together with the changes and consequences that follow surgery.
Knowing Your Risk Matters More Than Finding One Prevention Method
There is no single formula for preventing ovarian cancer.
Oral contraceptive use and certain reproductive and hormonal factors are associated with reduced ovarian cancer risk. For some women at average risk who are already undergoing pelvic surgery, removal of the fallopian tubes may be discussed as a risk-reducing option.
For women with inherited high risk, such as those with pathogenic BRCA1 or BRCA2 variants, more active strategies—including risk-reducing salpingo-oophorectomy—may be considered.
This is why the same prevention strategy is not appropriate for everyone.
Unnecessary testing or surgery is not the answer for someone at average risk, while healthy lifestyle habits alone cannot replace appropriate medical risk-reduction strategies for someone with a substantial inherited risk.
The most important starting point is understanding whether you are at average risk or at increased risk because of family history or inherited genetic factors, and then choosing strategies appropriate to that level of risk.
Final Takeaway
There is no proven method that can prevent all ovarian cancers.
What can be done depends largely on a person’s level of risk. Some factors are associated with a lower risk, while certain medical or surgical risk-reduction strategies may be appropriate in specific circumstances.
The more useful question is therefore not simply “How can I prevent ovarian cancer?” but “What is my level of risk, and which strategies are appropriate for reducing that risk?”
References
National Cancer Institute. Ovarian, Fallopian Tube, & Primary Peritoneal Cancers Prevention (PDQ®)–Health Professional Version. National Cancer Institute. (국립암연구소)
NCI — Ovarian Cancer Prevention (PDQ®)National Cancer Institute. Oral Contraceptives (Birth Control Pills) and Cancer Risk. National Cancer Institute.
— Supports the 30–50% lower ovarian cancer risk associated with oral contraceptive use and persistence of the association after discontinuation. (국립암연구소)
NCI — Oral Contraceptives and Cancer RiskNational Cancer Institute. Genetics of Breast and Gynecologic Cancers (PDQ®)–Health Professional Version. National Cancer Institute.
— Supports BRCA1/2 risk-reduction strategies and evidence that ovarian cancer risk is reduced by more than 90% after RRSO in women with documented BRCA1/2 pathogenic variants. (국립암연구소)
NCI — Genetics of Breast and Gynecologic Cancers (PDQ®)National Cancer Institute. BRCA1 and BRCA2 (PDQ®)–Health Professional Version. National Cancer Institute.
— Provides current evidence regarding RRSO for reducing ovarian and fallopian tube cancer risk in BRCA1/2 carriers. (국립암연구소)
NCI — BRCA1 and BRCA2 (PDQ®)American College of Obstetricians and Gynecologists. Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention. Committee Opinion No. 774.
— Supports discussion of opportunistic salpingectomy for women at population risk who are already undergoing pelvic surgery and emphasizes that it reduces but does not eliminate ovarian cancer risk. (ACOG)
ACOG — Opportunistic SalpingectomyAmerican College of Obstetricians and Gynecologists. BRCA1 and BRCA2 Mutations.
— Covers oral contraceptives, RRSO, surgical menopause, fertility considerations, and ongoing research into salpingectomy with delayed oophorectomy for BRCA carriers. (ACOG)
ACOG — BRCA1 and BRCA2 MutationsAmerican College of Obstetricians and Gynecologists. Hereditary Breast and Ovarian Cancer Syndrome. Practice Bulletin No. 182. Reaffirmed 2024.
— Clinical guidance on identifying and managing hereditary ovarian cancer risk and the role of genetic counseling and risk-reduction strategies. (ACOG)
ACOG — Hereditary Breast and Ovarian Cancer SyndromeAmerican College of Obstetricians and Gynecologists. Ovarian Cancer.
— Patient guidance covering high-risk management, salpingectomy, RRSO, BRCA1/2, fertility, and surgical menopause. (ACOG)
ACOG — Ovarian Cancer
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