Most ovarian cancers are not inherited, but some are caused by genes you can pass down

About 10 to 15 percent of ovarian cancers are hereditary, meaning they result from a gene mutation passed from a parent to a child. The most common culprits are mutations in the BRCA1 and BRCA2 genes. If you carry one of these mutations, your lifetime risk of developing ovarian cancer is significantly higher than the general population—roughly 35 to 70 percent depending on which gene and other factors. The remaining 85 to 90 percent of ovarian cancers happen by chance, with no family history involved.

Whether your cancer is genetic matters because it changes how doctors treat you, what screening your relatives might need, and what your own future health monitoring should look like. A genetic counselor or your oncologist can help you figure out whether testing makes sense for your situation.

Key Takeaways

  • BRCA1 and BRCA2 mutations account for most hereditary ovarian cancers, and inheriting one raises your lifetime risk substantially.
  • A family history of ovarian cancer, breast cancer, or pancreatic cancer—especially in multiple relatives or at younger ages—suggests genetic testing may be worth considering.
  • Genetic testing involves a blood or saliva sample and takes a few weeks for results; a genetic counselor explains what the results mean before and after the test.
  • If you carry a BRCA mutation, your close relatives (parents, siblings, children) have a 50 percent chance of carrying it too and may benefit from knowing their status.
  • Knowing your genetic status can guide treatment choices now and prevention strategies for the future.

How doctors tell if ovarian cancer might be genetic

Your doctor will look at your personal and family history first. Red flags include being diagnosed before age 50, having a relative with ovarian or breast cancer (especially before age 50), or having relatives with pancreatic cancer. Ashkenazi Jewish ancestry also raises the odds of carrying a BRCA mutation. If any of these apply to you, your doctor may recommend genetic testing.

The test itself is straightforward: a blood draw or saliva sample sent to a lab that looks for mutations in BRCA1, BRCA2, and sometimes other genes linked to ovarian cancer. Results typically come back in two to four weeks. Before the test, a genetic counselor will walk you through what a positive, negative, or uncertain result would mean for you. After results arrive, you meet with the counselor again to understand what to do next.

Not everyone with ovarian cancer needs genetic testing. If you were diagnosed at 65 or older with no family history, the odds of finding a hereditary mutation are low. Your oncologist can advise whether testing is worth pursuing in your case.

What BRCA mutations are and why they matter

BRCA1 and BRCA2 are tumor suppressor genes—they normally act as brakes on cell growth. When you inherit a mutated version, that brake is faulty from birth in every cell in your body. Over time, cells in the ovaries, breast, or other organs may accumulate additional damage and turn cancerous. You do not automatically get cancer just from carrying the mutation; it increases the risk substantially, but many people with BRCA mutations never develop cancer.

If you have ovarian cancer and carry a BRCA mutation, your treatment may differ. Some chemotherapy drugs work better against BRCA-related cancers. Newer drugs called PARP inhibitors (such as olaparib or rucaparib) can slow or stop cancer growth in people with BRCA mutations and are often used after initial treatment. Knowing your status opens these options.

Other genes besides BRCA1 and BRCA2 can raise ovarian cancer risk—including PALB2, RAD51C, and BRIP1—but they are less common. Your genetic counselor will explain which genes were tested and what any findings mean.

What to tell your family if you carry a mutation

If genetic testing shows you carry a BRCA or other cancer-risk mutation, your blood relatives should know. Your parents, siblings, and adult children each have a 50 percent chance of inheriting the same mutation. Knowing their status allows them to pursue screening, take preventive steps, or make informed choices about their own health.

You do not have to tell them yourself—genetic counselors and some cancer centers offer family communication services to help. Some people write a letter, others have a counselor call, and some prefer to tell relatives in person. There is no single right way, but earlier is generally better because relatives can act on the information.

If relatives carry the mutation but have not had cancer, they might pursue enhanced screening (more frequent mammograms, MRI, or transvaginal ultrasound) or preventive surgery (removing the ovaries and fallopian tubes, or the breasts). These are personal choices, and a genetic counselor can discuss the pros and cons with them.

Genetic testing costs and how to access it

Genetic testing for cancer risk typically costs $300 to $5,000 depending on how many genes are tested and which lab performs the work. Many insurance plans cover testing if you meet certain criteria—usually a personal or family history of cancer. Medicare and Medicaid often cover it as well, though coverage rules vary by state.

If cost is a barrier, some labs offer reduced-cost or free testing based on income. The National Cancer Institute's Cancer Information Service (1-800-4-CANCER) can point you toward testing options in your area. Your oncologist or a genetic counselor at your cancer center can also arrange testing and often handles insurance questions.

Genetic counselors are usually available through your hospital or cancer center at no extra charge beyond what your insurance covers. If your center does not have one, the National Society of Genetic Counselors website has a directory to find one near you.

What happens after you get your results

If testing shows you carry a mutation, your oncology team will review treatment options tailored to that finding. You may also be referred to a high-risk cancer clinic for long-term monitoring and prevention planning. Some people choose preventive surgery (removing remaining ovaries and fallopian tubes if you have not already) to lower the risk of future cancer.

If testing is negative—meaning no mutation was found—your cancer likely arose by chance. This is reassuring for your relatives, though it does not change your own treatment. You still need standard follow-up care with your oncologist.

If results are uncertain or show a variant of unknown significance, the lab may recommend retesting in the future as knowledge evolves. Your genetic counselor will explain what this means and whether it changes your care plan.

Frequently Asked Questions

If I have ovarian cancer, does that mean I definitely have a genetic mutation?

No. About 85 to 90 percent of ovarian cancers are not hereditary. You are more likely to carry a mutation if you were diagnosed young, have a strong family history of cancer, or are of Ashkenazi Jewish descent. Your doctor can discuss whether testing makes sense for you.

Can I pass a BRCA mutation to my children even if I did not inherit it from my parents?

No. BRCA mutations are inherited from a parent. If you carry one, you inherited it from your mother or father. If neither parent carries it, you do not have it. New mutations (arising spontaneously) are extremely rare in cancer-risk genes.

If my mother had ovarian cancer but genetic testing shows I do not carry a mutation, am I safe?

You are at lower risk than someone who carries a mutation, but you are not risk-free. Your mother's cancer may have been caused by a gene not included in standard testing, or it may have been sporadic. Talk with your doctor about whether screening or other precautions make sense for you.

What is the difference between genetic testing and the genetic test my cancer was already tested for?

Cancer tissue testing (called somatic testing) looks for mutations in the tumor itself and helps guide treatment. Genetic testing (called germline testing) looks at your blood or saliva to see if you were born with a mutation in every cell. Both are useful but answer different questions.

If I test positive for a BRCA mutation, can I prevent ovarian cancer?

You cannot eliminate the risk entirely, but you can lower it significantly. Removing your ovaries and fallopian tubes (called a salpingo-oophorectomy) reduces ovarian cancer risk by about 95 percent. The timing and whether to do this is a personal decision made with your doctor, considering your age, whether you want children, and other factors.