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We do not yet know what causes ovarian cancer. But we do know some of the risk factors involved. A risk factor is something that increases a person's chance of getting a disease. Different cancers have different risk factors. Some risk factors, such as smoking, can be controlled. Others, like a person's age or race, can't be changed.

Most cases of ovarian cancer are not explained by any known risk factors. It is important to remember that while risk factors increase the odds of getting a disease, they do not guarantee it will occur.

Here are some of the risk factors for the most common (epithelial) type of ovarian cancer:

Age: Most ovarian cancers happen after change of life (menopause). Half of all these cancers are found in women over the age of 65.

Obesity: A study from the ACS found a higher rate of death from ovarian cancer in women who were overweight. The risk went up by 50% in the heaviest women.

Menstrual periods: There seems to be a link between the number of periods (menstrual cycles) in a woman’s lifetime and her risk of getting ovarian cancer. Women who started having periods early (before 12 years of age) or who went through the change of life after the age of 50 have a small increased risk of ovarian cancer. The same is true for women who have not had children, or who had their first child after they were 30 years old.

Fertility drugs: Some studies have found that long-time use of one fertility drug (clomiphene citrate), especially if no pregnancy took place, may increase the risk of LMP tumors. But infertility also increases the risk, even without the use of fertility drugs. Research in this area is now going on. If you are taking this drug, you should talk to your doctor about the possible risks.

Family history: Ovarian cancer risk is higher among women whose close blood relatives (mother, sister, daughter) have (or had) this disease. The relatives can be from either the mother’s or father’s side of the family. There is a higher risk if ovarian cancer happened at an early age. About 1 in 10 cases of ovarian cancer are linked to gene changes that can be found with certain tests. These changes are linked to an increased risk of breast and colorectal cancer. Please see the section on prevention to learn about genetic counseling and testing.

Breast cancer: Women who have had breast cancer also have a higher risk of ovarian cancer.

Talcum powder: Some studies have shown a slight increase in risk of ovarian cancer among women who used talcum powder on the genital area. Asbestos in the powder may explain the link. But these products have been free of asbestos for more than 20 years. Proving the safety of newer products will require further follow-up studies.

Estrogen replacement therapy (ERT): Some studies suggest that long-term use (10 years or more) of ERT after menopause may slightly increase the risk of ovarian cancer. Other studies have not found any effect. Women who used ERT for longer than 10 years had almost double the risk compared to women who never used it. The risk was tripled for those who used it for 20 years or more.

Most of these findings have been for women who used estrogen alone, rather than for those taking combined estrogen and progesterone. But a recent study of women taking both drugs also showed an increased risk. Keep in mind, though, that the average lifetime risk for ovarian cancer is only about 2%). , or who stopped using it more than 15 years ago, seem to have a smaller increase in their risk of ovarian cancer. Combined hormone replacement therapy (HRT), where progesterone is given with the estrogen, seems to have little if any impact on ovarian cancer risk. ERT is rarely used any more except in women who have had a hysterectomy (removal of the uterus).

Since there are other factors to consider, you should talk with your doctor about the pros and cons of using HRT.

Revised: 11/9/2004