High risk for ovarian cancer

• HRT is not a contraindication for most individuals with a family history of ovarian cancer. However, women considered 'at high risk of ovarian cancer' require more detailed counselling and should be referred to a health care professional with expertise in menopause.
• In women at population risk of ovarian cancer, the evidence that HRT increases ovarian cancer risk is very limited. NICE says use of HRT very slightly increases the risk of ovarian cancer after 5 years of use, although the risk is small in absolute terms. See HRT risks section.
• In high-risk women, for example in those with risk factors for epithelial ovarian cancer due to BRCA mutations or Lynch syndrome, the underlying risk of ovarian cancer is increased. In high-risk women, risk reducing surgery may be offered.

NICE is currently developing a guideline on identifying and managing familial and genetic risk of ovarian cancer, which will cover HRT after risk reducing surgery for people at increased risk of ovarian cancer.