Overview

Ovarian cancer describes a set of malignant tumors that develop in or near the reproductive organs that produce eggs. Many readers use the term to mean cancer that begins in the ovary, but recent research has shown that some tumors classified as ovarian in origin may arise from adjacent tissues, notably the fallopian tube. Risk increases with age and is influenced by reproductive history, genetics and environmental factors. Because early symptoms are often vague, cancers of the ovary are frequently detected at an advanced stage.

Types and origins

Ovarian tumors are grouped by the type of cell from which they arise. The main categories are:

  • Epithelial tumors — the most common group, arising from the surface layer of the ovary or related tubal epithelium.
  • Germ cell tumors — arising from the cells that produce eggs; these are more common in younger people.
  • Sex cord–stromal tumors — developing from hormone-producing cells within the ovary.

High-grade serous carcinomas, a common epithelial subtype, are now often linked to precursors in the fimbrial end of the fallopian tube, which has changed thinking about early detection and prevention.

Risk factors and prevention

Recognized risk factors include older age, certain inherited gene variants (for example BRCA1 and BRCA2), a family history of ovarian or breast cancer, and never having been pregnant. Protective factors include pregnancy, breastfeeding and combined oral contraceptive use. Surgical procedures such as tubal ligation or removal of the fallopian tubes reduce risk in some settings. Genetic counselling and testing are recommended when family history or personal factors raise suspicion.

Signs, diagnosis and staging

Symptoms are often nonspecific: persistent bloating, pelvic or abdominal pain, difficulty eating or early satiety, and urinary urgency. Because these symptoms overlap with common benign conditions, diagnosis relies on clinical examination and tests:

  • Pelvic ultrasound and cross-sectional imaging (CT or MRI)
  • Blood tests including cancer antigen markers (for example CA‑125) in selected contexts
  • Diagnostic surgery and microscopic examination (histology) to confirm type and stage

Accurate surgical staging is important to guide treatment and to estimate prognosis.

Treatment and prognosis

Treatment depends on tumor type and stage. Standard approaches include surgery to remove the tumor and affected tissue and systemic therapies such as platinum-based chemotherapy. For certain patients, targeted therapies and maintenance treatments (including PARP inhibitors for tumors with specific DNA repair defects) may improve outcomes. Early-stage disease treated with appropriate surgery has a much better prognosis than advanced disease; overall survival varies widely by stage and histologic subtype. Ovarian malignancies are a major cause of gynecologic cancer deaths, which has driven research into earlier detection and improved therapies.

Notable facts and ongoing challenges

Two persistent challenges are the lack of a reliable population screening test and the tendency for symptoms to be subtle. Current research focuses on understanding origins (for example links to the fallopian tube), refining risk stratification through genetics, and developing better biomarkers and treatments. For those with a family history, referral to genetics services can inform both prevention and early-detection strategies. For more general information see ovarian cancer resources.