There is no way to truly prevent ovarian cancer. One would think that removal of the fallopian tubes and ovaries would prevent the disease but this is not always the case (primary peritoneal cancer can arise in the pelvis even after the ovaries have been removed). However, there are ways to significantly reduce your risk. If a woman takes birth control pills for more than 10 years, then her risk of ovarian cancer drops significantly. Tubal ligation has long been known to decrease the risk of ovarian cancer. Recently, removal of the entire tube has been shown to further decrease the risk. This procedure, called a salpingectomy, can be considered by any woman considering a tubal ligation. Removal of the ovaries does decrease the risk of cancer, but at the cost of increasing death due to heart disease and other causes. Currently, this procedure is often saved for specific situations (genetic risk, family history) in patients under 60 to 65 years of age and is not used in the general population. Until recently, if a woman was close to menopause and was undergoing surgery, then the ovaries and tubes would be removed. The recent studies indicating that many of these cancers actually come from the fallopian tube, and the studies indicating that removal of even postmenopausal ovaries causes other problems has caused a significant shift in this philosophy. Certainly, the tubes should be removed at the time of hysterectomy for any woman. The need for removal of the ovaries is much more uncertain.
Genetic abnormalities are an exception to this recommendation. If a patient is positive for a BRCA or Lynch syndrome genetic defect (mutation), then the patient should strongly consider removal of her tubes and ovaries to decrease the chance of her getting a cancer. Women with these mutations are at a very high risk of ovarian cancer, and in this situation the risk of heart disease is not as significant as dying of one of these cancers. This can be planned at the end of child bearing, or at age 35. Each patient is recommended to discuss this with her doctor, or a genetic counselor.