Ovarian cancer is a growth of abnormal malignant cells in and around your ovaries and fallopian tubes. Symptoms are usually subtle and can be easily mistaken for other health problems. They include:

  • persistent bloating
  • pelvic or abdominal pain
  • difficulty eating
  • a need to urinate more urgently or more often than usual

Currently, there’s no effective screening test for ovarian cancer. But if the disease isn’t diagnosed and treated early enough, it can spread to other parts of the body. In some cases, it can be fatal.

There are several links between ovarian cancer and age. Your chances of developing ovarian cancer increase as you get older. The age at which you experience certain reproductive events, such as your first period or pregnancy, also affects your risk of getting ovarian cancer.

What is your risk of ovarian cancer before you turn 40?

Ovarian cancer is rare in women younger than 40. The latest data from the National Cancer Institute (NCI) found that the percentage of new cases was 4 percent between the ages of 20 and 34. The percentage of ovarian cancer-related deaths in the same age group was less than 1 percent.

You’re at increased risk of developing ovarian cancer if you:

  • were diagnosed with breast cancer before you turned 40
  • have two or more close relatives with breast cancer before the age of 50
  • have family members with ovarian cancer diagnosed at any age

As with other cancers, your risk of getting ovarian cancer increases as you get older. Nearly 25 percent of new cases reported from 2011 to 2015 were between the ages of 55 and 64.

Research also shows that the median age of diagnosis is 63. Most ovarian cancers develop after menopause.

Of newly diagnosed cases of ovarian cancer, 22 percent are women between the ages of 65 and 74. Researchers report that survival rates have worsened among older women. The percent of ovarian cancer deaths is the highest among women aged 65 to 74.

According to an article published in the 2015 American Society of Clinical Oncology (ASCO) Educational Book, one theory is that older women are less likely to seek out a specialist (gynecologic oncologist), which leads to less aggressive surgical efforts.

Your reproductive history can play a role in your odds of developing ovarian cancer, particularly if you:

  • started menstruating before the age of 12
  • gave birth to your first child after you turned 30
  • experienced menopause after the age of 50

Other known risk factors associated with reproduction include infertility and never having taken oral contraceptives.

Age and reproductive history aren’t the only risk factors for ovarian cancer. Other risk factors include:

  • Genetics. Certain gene mutations, such as BRCA1 and BRCA2, significantly raise your risk of ovarian cancer, as well as breast cancer. You can inherit these mutations from your mother or father. You also have a higher risk for these mutations if you have an Eastern European or Ashkenazi Jewish background.
  • Family history. You’re more likely to develop ovarian cancer if you have a birth mother, sister, or daughter who has had ovarian cancer.
  • Breast cancer. If you’ve previously been diagnosed with breast cancer, you’re at higher risk of developing ovarian cancer.
  • Infertility. Being infertile, or using fertility drugs, may increase your risk.
  • Hormone replacement therapy. Using hormone replacement therapy after menopause raises your risk. This is particularly true if you take estrogen alone for five years or more.
  • Obesity. Having a body mass index (BMI) of 30 or more puts you at greater risk of developing ovarian cancer.

Keep in mind that having these risk factors for ovarian cancer doesn’t mean you’re going to develop it. On the other hand, some women with no risk factors will develop this cancer.

Talk to your doctor to learn more about your risk factors and if there are any special recommendations based on your risk.

Certain lifestyle choices and medical interventions may lower your chances of developing ovarian cancer. For example:

  • Breastfeeding may lower your risk of this disease.
  • Taking birth control pills or oral contraceptives may also help. Being on the pill for as little as three to six months may reduce your chances of getting this type of cancer, according to the American Cancer Society. This benefit lasts for years after you stop taking the pill.
  • Having the fallopian tubes tied also may lower your chances of getting ovarian cancer by up to two-thirds. This procedure is known as tubal ligation.
  • Having your uterus removed may reduce your risk by about one-third. This procedure is called a hysterectomy.
  • If you have BRCA gene mutations, getting your ovaries removed may lower your risk of ovarian cancer by 80 to 90 percent. This procedure is known as an oophorectomy. It may also lower your chances of developing breast cancer.

Your doctor can help you weigh the potential benefits and risks of surgical procedures such as tubal ligation, hysterectomy, and oophorectomy.

Eating a well-balanced diet may also be beneficial, although its effects on ovarian cancer risk aren’t yet known. Among other benefits, a nutritious diet improves your overall well-being and can help lower your risk of developing several other types of cancer. Eat a wide variety of fruits, vegetables, and whole grains. Limit your consumption of red meat, processed meat, and other processed foods.

There’s no sure way to prevent ovarian cancer. Overall, the risk of developing this disease is small. Talk to your doctor if you have any concerns, or if you have a family history of ovarian cancer.