Ovarian Cancer Risk Assessment

The chance of developing ovarian cancer increases with age; it’s higher in women older than 40. Another risk factor is greater lifetime number of menstrual periods, which happens if your first menstrual period started before age 12, you were never pregnant, you gave birth to your first child after age 30, or you started menopause after age 55.

A family history of ovarian cancer, breast cancer, or certain other cancers also increases risk. At NYU Langone, our gynecologic oncologists—doctors who specialize in diagnosing and treating cancers that develop in a woman’s reproductive organs—work closely with our genetic counselors and breast cancer doctors. This team helps you assess and manage your genetic risk.

Certain gene mutations, such as those in the breast and ovarian cancer genes BRCA1 and BRCA2, while relatively rare, greatly increase the lifetime risk of developing ovarian cancer. Healthy versions of these genes produce proteins that help prevent tumor growth. When they mutate, the proteins don’t function properly, allowing ovarian cancer to develop.

Similarly, women may be at risk if they have mutations in certain genes associated with Lynch syndrome, previously called hereditary nonpolyposis colorectal cancer (HNPCC) syndrome. In addition to ovarian cancer, these mutations increase lifetime risk of endometrial cancers and colorectal cancers, among others.

BRCA1, BRCA2, and the gene mutations that accompany Lynch syndrome are the most well known genetic changes associated with ovarian cancer. But researchers have identified multiple new genes in which mutations increase ovarian cancer risk.

Our gynecologic oncologists and genetic counselors work together to help you understand the risks associated with these gene mutations and to decide whether you want to be tested for them. They can also discuss what the implications are if test results show gene mutations are present. These include what approaches to preventive care you may want to consider and whether family members who may also have these mutations should be tested.

If you and your doctors and genetic counselors decide genetic testing is appropriate, blood tests that may identify mutations associated with ovarian cancer and other malignancies can be done at NYU Langone. If your test results are positive, our doctors offer a high-risk ovarian cancer screening program.

Since these mutations also increase the risk of breast cancer, your doctor may recommend mammograms and other imaging tests, and you may be referred to a breast cancer doctor.

Our doctors offer screening, which involves a combination of a transvaginal ultrasound and a blood test called CA-125, to women at increased genetic risk of ovarian cancer. Doctors generally recommend that these women be screened every six months. Your gynecologic oncologist can discuss at what age screening should start for you.

Transvaginal Ultrasound

This imaging test uses sound waves to create images on a computer monitor of the ovaries and fallopian tubes, which carry eggs to the uterus. During this exam, a wand-like device is inserted into the vagina to help doctors look for possible early cancers in the ovaries, fallopian tubes, and uterus.

Serum CA-125 Test

This test measures levels of the protein CA-125 in the blood, which can be elevated in women who have the most common type of ovarian cancer. However, many other factors not related to cancer can contribute to high levels of CA-125. Comparing several CA-125 test results over time to a baseline, a level recorded at your first appointment, may give a more accurate assessment of ovarian cancer risk.