There is no guaranteed way to prevent ovarian cancer, but several factors can meaningfully lower your risk. Some are choices you can make today, others involve conversations with a surgeon or genetic counselor, and a few are reproductive experiences that offer protection you may not have known about. What makes ovarian cancer particularly tricky is that no reliable screening test exists for the general population, so risk reduction is the most practical strategy available.
Why Screening Isn’t the Answer
Unlike cervical cancer or breast cancer, ovarian cancer has no effective screening tool for average-risk women. The blood test most commonly associated with ovarian cancer detection, CA-125, catches only 50 to 62% of early-stage cases. It also produces false positives: about 5% of women with benign conditions like endometriosis show elevated levels, and even 1% of completely healthy women do. For a disease as rare as ovarian cancer, an ideal screening test would need at least 99.6% specificity, and CA-125 falls far short at roughly 73 to 77%.
The largest trial ever conducted on ovarian cancer screening, a UK study of more than 200,000 women followed for years, found no significant reduction in deaths from the disease in screened groups compared to unscreened groups. Because of these results, routine population screening is not recommended. That makes prevention, rather than early detection, the most important focus.
Oral Contraceptives Offer Strong Protection
Birth control pills are one of the most well-documented ways to reduce ovarian cancer risk. Women who have ever used oral contraceptives have a 30 to 50% lower risk compared to women who have never used them. The longer you use them, the greater the benefit, and the protection persists for up to 30 years after you stop taking them.
This doesn’t mean you should start the pill solely for cancer prevention. Oral contraceptives carry their own risks, including a small increase in breast cancer risk and blood clot risk. But if you’re already considering hormonal birth control for other reasons, the ovarian cancer benefit is a significant added advantage worth factoring into your decision.
Pregnancy and Breastfeeding Lower Risk
Each full-term pregnancy reduces ovarian cancer risk, likely because it temporarily stops ovulation. The more lifetime ovulatory cycles you have, the higher your risk, so anything that interrupts ovulation tends to be protective.
Breastfeeding adds an additional layer of protection. Even a short period of nursing helps: breastfeeding for just one to three months per child is associated with an 18% reduction in risk. Breastfeeding for 12 months or longer is linked to a 34% reduction. These numbers come from a large 2020 analysis and represent one of the clearest lifestyle-related risk reductions available. If you’re able to breastfeed and planning to do so, the ovarian cancer benefit is one more reason to continue for as long as it works for you.
Surgical Options During Other Procedures
A growing body of evidence suggests that many ovarian cancers actually start in the fallopian tubes, not the ovaries themselves. This has changed how gynecologic surgeons think about prevention. The American College of Obstetricians and Gynecologists now recommends that women at average risk consider having their fallopian tubes removed (a salpingectomy) if they’re already undergoing pelvic surgery for another reason.
Specifically, this applies in three situations: if you’re having a hysterectomy, if you’re choosing permanent contraception (where tube removal can replace a traditional tubal ligation), or if you’re having another pelvic surgery where tube removal can be added without significant additional risk. The idea is straightforward: since you’re already in surgery, removing the tubes eliminates the tissue where many of these cancers originate. This doesn’t affect your hormone levels the way removing your ovaries would, and it doesn’t trigger early menopause.
If you’re planning any pelvic surgery and you’re done having children, it’s worth asking your surgeon whether a salpingectomy makes sense as part of that procedure.
Genetic Risk and What to Do About It
Most ovarian cancers are not inherited, but a significant minority are driven by mutations in the BRCA1 or BRCA2 genes. Women with a BRCA1 mutation face an estimated 39 to 44% lifetime risk of ovarian cancer. For BRCA2 carriers, the risk is 11 to 17%. Compare this to the roughly 1.2% lifetime risk in the general population, and the difference is dramatic.
If you have a strong family history of ovarian or breast cancer, particularly in first-degree relatives or at young ages, genetic counseling and testing can clarify your risk. For women who test positive for BRCA1 or BRCA2 mutations, removing both the ovaries and fallopian tubes after completing childbearing (typically recommended between ages 35 and 45, depending on the mutation) is the most effective prevention strategy available. This surgery reduces ovarian cancer risk by roughly 80 to 90% in high-risk women, though it does induce surgical menopause.
Other inherited syndromes, including Lynch syndrome, also increase ovarian cancer risk, so genetic evaluation matters even if BRCA isn’t involved.
Body Weight and Ovarian Cancer
Carrying excess body fat is associated with a modest but real increase in risk. The American Institute for Cancer Research found a dose-response relationship: every five-point increase in BMI raises ovarian cancer risk by about 6%. That means a woman with a BMI of 35 faces a measurably higher risk than a woman at 25, though the absolute numbers remain small for any individual.
Maintaining a healthy weight through regular physical activity and balanced nutrition won’t eliminate your risk, but it contributes to a lower overall cancer risk profile across many types, ovarian included.
What About Aspirin and Other Medications
You may have seen headlines about aspirin reducing ovarian cancer risk. The evidence is mixed. A large trial of more than 41,000 postmenopausal women found that daily low-dose aspirin was not significantly associated with reduced ovarian cancer risk overall. There was a possible benefit in women under 70, but the findings weren’t strong enough to support a general recommendation. Aspirin also carries bleeding risks, so taking it specifically for ovarian cancer prevention isn’t currently advised.
Putting It Together
The factors with the strongest evidence for reducing ovarian cancer risk are oral contraceptive use, breastfeeding, surgical removal of the fallopian tubes when another surgery is already planned, and genetic testing followed by preventive surgery for high-risk women. Maintaining a healthy weight offers a smaller but genuine benefit. No screening test can reliably catch ovarian cancer early in average-risk women, which makes these proactive steps all the more important.
Not every protective factor is within your control. You can’t go back in time to breastfeed longer or choose to have had children. But knowing which factors matter lets you make informed decisions going forward, whether that’s asking about tube removal at your next surgery, considering genetic testing if your family history warrants it, or simply understanding why your doctor hasn’t recommended an ovarian cancer screening test.