Most ovarian cancer occurs by chance, but up to 20% of cases are hereditary. In some families, a specific genetic change (pathogenic variant) can be identified, allowing for tailored screening and risk-reducing strategies.

Genes contain instructions that control how the body develops and functions. Some genes help prevent cancer, but if a pathogenic variant is present, it can increase the risk of ovarian cancer.

Anyone diagnosed with high-grade serous ovarian cancer

Individuals with a family history of ovarian cancer, particularly if there is:

• Breast cancer diagnosed before age 45, bilateral breast cancer, or male breast cancer
• Jewish ancestry with a history of breast, ovarian, or prostate cancer
• Bowel or womb cancer diagnosed before age 50

Several genes are associated with an increased risk of ovarian cancer. At Check4Cancer, patients having cancer treatment who have insurance are usually tested for these. They include:

• ATM, BARD1, BRCA1, BRCA2, BRIP1, CHEK2, EPCAM, MLH1, MSH2, MSH6, PALB2, PTEN, RAD51C, RAD51D, STK11, TP53     

A more comprehensive 31 gene panel is also available to self-pay patients. These include:

• APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4, CDKN2A, CHEK2, EPCAM, HOXB13, MLH1, MSH2, MSH6, MUTYH, NF1, NTHL1, PALB2, PMS2, POLD1, POLE, PTEN, RAD51C, RAD51D, SMAD4, STK11, TP53, VHL.

Yes. Genes come in pairs, one inherited from each parent. Most hereditary cancer syndromes follow a dominant inheritance pattern, meaning a parent with a pathogenic variant has a 50% chance of passing it on to their children. The risk of ovarian cancer can be inherited from either side of the family.

Genetic testing can help:

• Determine the best chemotherapy options for those diagnosed with cancer
• Identify a family’s risk and guide screening recommendations
• Consider risk-reducing strategies to lower cancer risk
• Identify those individuals who may benefit from other treatments, such as PARP inhibitors

• Pathogenic variant detected – A gene variant that increases ovarian cancer risk is found. This may impact treatment decisions, screening recommendations, or risk-reducing strategies.
• Variant of uncertain significance (VUS) – A genetic change is detected, but its impact on cancer risk is unclear. Screening recommendations will be based on family history.
• No variant found – No known risk-increasing variant is detected, but an undetectable or undiscovered variant may still exist. Cancer screening may still be beneficial.

If a pathogenic variant is found:

• It explains why ovarian cancer developed (if already diagnosed)
• Certain treatments may be more effective
• Additional screening or risk-reducing options may be considered
• Family members may be eligible for predictive genetic testing

It’s important to recognize possible symptoms and seek medical advice if they persist:

• Persistent bloating or increased abdominal size
• Difficulty eating or feeling full quickly
• Pelvic or abdominal pain
• Frequent or urgent need to urinate

Most people with these symptoms do not have cancer, but it’s always best to get them checked.

Several factors may raise the risk, including:

• Diabetes
• Endometriosis
• Ovarian cysts (certain types)
• Exposure to asbestos

Protective factors that reduce risk include:

• Pregnancy and childbirth
• Breastfeeding
• Tubal ligation (female sterilization) – Reduces risk by about 35%
• Oral contraceptives (birth control pills) – Can lower the risk by up to 50% when taken for five or more years

If you're concerned about your ovarian cancer risk, talk to your doctor about personalised screening and prevention strategies.