Ovarian cancer arises from cells of the ovary, fallopian tube or peritoneum and is often diagnosed late because early stages cause few or vague symptoms. Research shows that more than 90 percent of cases are epithelial ovarian cancers, with high grade serous carcinoma the most common and aggressive subtype. Increasing age, family history of ovarian or breast cancer, inherited BRCA1 or BRCA2 mutations, and certain reproductive factors increase risk. Protective factors include use of combined oral contraceptives, multiple pregnancies and breastfeeding, which reduce lifetime ovulation.

Current work highlights the importance of the fallopian tube as a likely origin for many high grade serous cancers, shifting strategies for prevention and early detection. For women with a strong genetic risk, removal of fallopian tubes and ovaries after childbearing substantially lowers the chance of developing the disease.

Screening with ultrasound and CA125 blood tests has not yet reduced mortality in the general population, so research is focused on better biomarkers, multimarker panels and algorithms that track changes over time. Treatment usually combines surgery and platinum based chemotherapy. Studies are refining the extent and timing of surgery, including interval debulking after initial chemotherapy.

Targeted therapies are a major focus. PARP inhibitors have improved outcomes for patients with BRCA mutations or tumors with homologous recombination deficiency, and antiangiogenic drugs help control tumor growth in some cases. Ongoing trials are evaluating combinations of targeted agents, immunotherapies and maintenance treatments, as well as personalized approaches based on tumor genetics to improve survival and limit relapse.