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If ovarian cancer runs in your family, you may worry that you could get it, too. But even if two close family members (such as your mother and sister) have had ovarian cancer, you still have better than a 9 in 10 chance of never getting it.

Your family's health is important in working out your own risk of getting ovarian cancer. This is because you can get genes from your father's or mother's family that increase your risk.

But it's not just your family's history with ovarian cancer that you need to consider. You should also tell your doctor whether breast cancer and other cancers (such as cancer of the womb, colon and prostate) run in your family. It's especially important to note if a relative got cancer before age 50, because this may increase your risk.

However, few women with ovarian cancer (less than 1 in 20) have a relative, such as a mother or sister, who has had ovarian cancer.¹

If you're worried that your family could have cancer genes, you may want to see a genetic counselor. Your doctor can tell you if this will help. A genetic counselor will ask you:

• Which of your relatives have had cancer?
• What kind of cancer did they have?
• How old were they when they got it?
• What happened to them?

Your counselor will then work out if your chance of getting ovarian cancer (or another type of cancer) is higher than average.

Two genes have been linked to ovarian cancer in families. They're called BRCA1 and BRCA2. A blood test can show if you have changes in these genes (called mutations) that might increase your chance of getting ovarian cancer. Some changes also increase your chance of getting breast cancer.

If you have changes in these genes, it doesn't mean that you'll get ovarian cancer for sure. It just means that you're more likely to get it than someone who doesn't have the changes. Your chance of getting ovarian cancer may be just a bit higher or it may be a lot higher.²

But other things also affect your risk. For example, taking birth control pills, having children and breastfeeding all reduce your chance of getting ovarian cancer. To learn more, see Factors that affect your risk.

Your genetic counselor will look at all of these factors and work out your chance of getting ovarian cancer. Then you can talk about what you can do.

If your risk of ovarian cancer is high, it's important to have regular checkups. You can also talk with your doctor about several other options you have.

There's no good test for finding ovarian cancer early on. But doctors are looking at a blood test to see if it can help.

This test shows how much of a protein called CA 125 you have in your blood. Women with ovarian cancer tend to have lots of it. So if you have high levels of CA 125, it could mean that you have early ovarian cancer.

However, there are problems with this test. For example, only about half the women with early ovarian cancer have raised levels of CA 125. Plus, a higher than normal CA 125 level could be caused by other health problems, not just ovarian cancer.

This means that if the CA 125 test was used on its own, some women with ovarian cancer would be missed. (Doctors call this a false negative test result.)

And the test might come up positive in some women who don't have ovarian cancer. These women would then be put through the anxiety of thinking that they might have cancer when, in fact, they don't. (Doctors call this a false positive test result.)

The CA 125 test is often used with another test that uses ultrasound through your vagina to look at your ovaries (called transvaginal ultrasound).

During this exam, a doctor puts an ultrasound probe into your vagina to look at your ovaries. This works better than doing the ultrasound over your abdomen. But even so, it is very difficult to tell what is cancer and what is a harmless lump, such as a cyst, just by looking at your ovary.

If you have a very high risk of getting ovarian cancer, you may want to consider having an operation to take out your ovaries. This greatly reduces your chance of getting ovarian cancer.³ It also reduces your chance of getting breast cancer. (Some women who have changes in two genes that have been linked to ovarian cancer and breast cancer, called BRCA1 and BRCA2, are at high risk for both cancers.)

But removing your ovaries doesn't take away all the risk of getting ovarian cancer. This is because there may be some cells left behind after surgery. These cells could turn into cancer in the place where your ovaries used to be. They could also spread to other areas. But the chance of this happening is very small.³

If you have this operation to remove your ovaries, there are some things you should know.

• You can't get pregnant naturally after this surgery. But you may be able to get pregnant by having fertility treatments.
• If you haven't reached menopause yet, having your ovaries taken out may cause symptoms of menopause, such as hot flashes, sweating at night and a dry vagina, as well as thinning of your bones (called osteoporosis). You can take treatments to ease some of these problems. For more information, see our section on menopause.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.