Ovarian cancer is often referred to as a silent disease because it rarely causes noticeable symptoms in its early stages, leading to diagnosis after the cancer has advanced. This difficulty in early detection makes proactive risk reduction a primary focus for long-term health management. While risk factors like age and genetic predisposition cannot be altered, many others are modifiable through deliberate actions. Understanding these steps empowers individuals to significantly lower their lifetime risk, covering strategies from lifestyle adjustments and hormonal interventions to surgical options.
Lifestyle Factors That Reduce Risk
Maintaining a healthy body weight represents a primary defense against developing ovarian cancer, as obesity is consistently associated with an increased risk. Excess adipose tissue produces higher levels of estrogen, which can stimulate the growth of cancer cells. Achieving a body mass index within the healthy range reduces this hormonal stimulation and lowers overall cancer risk.
Regular physical activity complements weight management and contributes independently to risk reduction. Engaging in structured exercise, such as aiming for 150 minutes of moderate aerobic activity weekly, helps regulate hormone levels and reduces chronic inflammation throughout the body. Even activities that reduce sedentary time, such as taking short, frequent walks, can produce beneficial effects on metabolic health and cancer prevention.
Dietary choices play a supporting role in this protective strategy by reducing inflammation. A diet rich in fiber, found in vegetables, fruits, and whole grains, is associated with a lower risk of ovarian cancer. These foods provide beneficial compounds like antioxidants and anti-inflammatory agents, which protect cells from damage that can lead to malignant transformation.
Eliminating tobacco use offers another protective measure, as smoking is identified as a risk factor for several types of ovarian cancer. Quitting smoking removes the exposure to carcinogens that can directly damage cell DNA and initiate the development of cancer. This action provides wide-ranging health benefits that extend far beyond gynecologic cancer prevention.
Hormonal and Reproductive History Protections
The use of combined Oral Contraceptive Pills (OCPs) is one of the most effective and widely accessible methods for reducing ovarian cancer risk in the general population. The protective effect is strongly tied to the duration of use, with a reduction in risk occurring after just a few months. Using OCPs for five years is associated with an approximately 40% reduction in risk, and this protection can persist for decades after the medication is stopped.
The mechanism behind this protective effect is the suppression of ovulation, which OCPs are designed to halt. Each time an ovary releases an egg, the surface epithelium must repair itself, creating an opportunity for genetic errors to occur. By preventing ovulation, OCPs reduce the number of these repair cycles over a woman’s reproductive lifetime. The synthetic hormones in the pill also create a hormonal environment that is less stimulatory to potential cancer cells.
A woman’s reproductive history also provides a natural protective shield, largely due to the same mechanism of suppressed ovulation. Having one or more full-term pregnancies lowers the risk of ovarian cancer by approximately 29% compared to never being pregnant. The protective effect increases with the number of pregnancies, with the first three providing the most substantial benefit.
Breastfeeding extends this natural protection by further suppressing ovulation and altering the hormonal profile. Women who have ever breastfed experience a risk reduction of about 22% to 24%. Extending the duration of breastfeeding increases this benefit, with 12 or more months of total breastfeeding time associated with a 34% lower risk.
Surgical Options for High-Risk Individuals
For individuals with a significantly elevated risk, particularly those with inherited genetic mutations like BRCA1 or BRCA2, surgical interventions offer the most profound risk reduction. The most definitive procedure is a Risk-Reducing Salpingo-Oophorectomy (RRSO), which involves the removal of both ovaries and fallopian tubes. RRSO is proven to reduce the risk of ovarian and fallopian tube cancer by over 80% to 96% in those with a high-risk mutation.
RRSO is typically recommended between the ages of 35 and 45, or once a woman has completed childbearing, though the timing depends on the specific genetic mutation. Although the procedure induces immediate surgical menopause, hormone replacement therapy can often be used to manage symptoms and long-term health consequences. A small risk of primary peritoneal cancer remains after RRSO, as this cancer can arise from tissue lining the abdomen.
For the general population, or those undergoing other pelvic procedures, an approach called opportunistic salpingectomy has emerged as a strategy for prevention. This procedure involves the removal of the fallopian tubes while leaving the ovaries intact to preserve hormonal function. This strategy is based on the discovery that the most common and aggressive type of ovarian cancer, high-grade serous carcinoma, often originates in the fimbriated end of the fallopian tube.
Opportunistic salpingectomy is performed during other planned surgeries, such as a hysterectomy or in place of a standard tubal ligation for permanent contraception. This procedure is associated with a dramatic reduction in the risk of serous ovarian cancer. Even a traditional tubal ligation, which blocks the fallopian tubes, provides a moderate reduction in ovarian cancer risk, estimated to be between 24% and 36%.