Great question. Not many. Most ovarian cancer just happens because of bad luck. Less than 25% of ovarian cancer is caused by an inherited identifiable genetic mutation. Certainly a patient with a family history of ovarian cancer should be evaluated to determine if she qualifies for BRCA testing. This can be done either by a formally-trained genetic counselor or by less-formally-trained healthcare providers who have been educated about risk assessment for various cancers including ovarian cancer. Ovarian cancer happens to about 1% of women with no risk factors. If a first degree relative has ovarian cancer, the risk goes up to 4%. If the patient has a BRCA mutation, the risk can be as high as 44%. With Lynch syndrome, a combination of uterine, colon, ovarian, and a few other cancers, the risk is between 10-15%. Women who have never had a baby, who had early menarche and late menopause, and who have never taken the pill are at slightly higher risk given that there ovaries never took a break from ovulating. There is controversy over whether "super ovulation" (using medications to increase the number of eggs ovulated) used in infertility patients increases the risk of ovarian cancer. Patients with any of these factors are evaluated regularly and advised to report any changes in bowel or bladder habits or pelvic symptoms that might be associated with ovarian cancer (see prior question).
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