FAQ: Ovarian cancer risk factors

Q: Does a person’s risk of ovarian cancer increase as they get older?

A: Yes. As with most cancers, the risk of developing ovarian cancer increases with age. Over 80% of cases are diagnosed in women who are over 50, i.e. post-menopausal.

Q: Does this mean that going through the menopause is a risk factor for ovarian cancer?

A: There are around 7,400 cases of ovarian cancer, and most are diagnosed in women over 50 (the official age for menopause in the UK is 51).  The process of going through the menopause isn’t found to increase the risk of ovarian cancer, but factors such as age do increase a person’s risk of ovarian cancer and are associated with the menopause.

Q: What is HRT and is it a big ovarian cancer risk factor?

A: Hormone replacement therapy is a treatment used to relieve menopausal symptoms such as hot flushes and mood changes. It involves replacing the hormones oestrogen and progesterone that are at a lower level during the menopause, via a tablet, patch, cream, gel or pessary. It used to be thought that using HRT was found to increase someone’s risk of ovarian cancer by 43%, but further analysis of the research is now suggesting otherwise. If there is a risk associated with HRT, it’s important to put that risk into context. Ovarian cancer isn’t a common cancer, so if for example the increased risk of ovarian cancer was 43%, for every 1,000 women using HRT for five years, there would be one additional ovarian cancer diagnosis. For the vast majority of people, the overall benefits of HRT hugely outweigh any potential risks. We have an in-depth menopause blog coming up, which will be looking into HRT in much more detail, so watch this space.

Q: If someone has had IVF, are they more likely to get ovarian cancer?

A: There is a slight correlation between the number of women who have had IVF treatment and the number of ovarian cancer cases. However, there isn’t current evidence suggesting that IVF actually causes ovarian cancer. It’s likely that more ovarian cancers are detected amongst women who have had IVF as they are a) under greater surveillance than the ‘average’ woman and that b) hormonal problems and infertility are the factors increasing the risk of ovarian cancer rather than the actual IVF treatment.

Q: Is ovarian cancer hereditary?

A: Cancer isn’t hereditary, but the risk of developing certain cancers can be passed on through genetic mutations or ‘faulty genes’. Around 15-20% of ovarian cancer cases are due to an inherited gene mutation, most commonly BRCA1/2. Women with faulty BRCA1/2 genes are at an increased risk of breast and ovarian cancer.

Q: How do I know if I’m a BRCA mutation carrier?

A: Knowing your family’s medical history plays a crucial part in testing for the BRCA gene mutation. If two or more first-degree relatives (parent, sibling, child) on the same side of your family with a breast and/or ovarian diagnosis then it’s possible that there is a faulty BRCA gene being passed on. Your GP can refer you for genetic testing.

Q: Does the pill cause ovarian cancer?

A: The combined contraceptive pill (the one that most people who take the pill will be on) actually reduces the risk of ovarian cancer rather than increases it, as taking the pill prevents ovulation. The reduction in ovarian cancer risk isn’t a big enough reason to start taking the contraceptive pill, but if you do make an informed choice with the help of your GP and start using the pill, then this is one of the benefits.

Q: If preventing ovulation reduces the risk of ovarian cancer, does that mean ovulation increases it?

A: Yes, every time an egg is released from the ovary (ovulation), the surface of the ovary breaks to let the egg out. This damages the surface of the ovary and it needs to be repaired. The risk of cell damage increases each time ovulation occurs. This could be why women who take the contraceptive pill, have multiple pregnancies and breastfeed have a lower risk of ovarian cancer as eggs aren’t being released during these periods. The fewer times someone ovulates, the lower their lifetime risk of ovarian cancer.

Q: Is being overweight linked to ovarian cancer?

A: Recent studies have shown that there is a link between obesity and ovarian cancer, but this increase really is minimal.

Q: Can bad bacteria cause ovarian cancer?

A: A recent study by UCL has shown that women with ovarian cancer and those in high-risk groups (BRCA) have fewer healthy vaginal bacteria than women who don’t have ovarian cancer or aren’t considered high-risk. The research team will continue with this study and test the fallopian tubes (where most ovarian cancers begin) for bad bacteria, so there isn’t a clear answer at the moment.