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No. Removing both ovaries substantially lowers ovarian cancer risk, but it does not make the risk zero. Cancer can still arise in the fallopian tubes or the lining of the abdomen, called the peritoneum. Risk-reducing surgery is not a guarantee, and the amount of benefit depends on a person’s inherited risk and the specific operation.

What does removing the ovaries actually prevent?

An oophorectomy removes one or both ovaries. A bilateral salpingo-oophorectomy (BSO) removes both ovaries and both fallopian tubes. These operations are not interchangeable: many high-grade serous cancers are thought to begin in the fallopian tubes, while some ovarian cancers originate in the ovaries. For that reason, guidance about risk-reducing surgery often addresses removal of both structures, rather than ovary removal alone. The American College of Obstetricians and Gynecologists (ACOG) discusses this relationship and the distinction between procedures in its Committee Opinion on opportunistic salpingectomy.

Even after risk-reducing salpingo-oophorectomy, a small risk of primary peritoneal cancer remains. This cancer develops in the peritoneum, the tissue lining the abdomen, and is related to ovarian and fallopian-tube cancers but is not cancer of an ovary that has been removed. The National Cancer Institute (NCI) notes that residual risk may reflect cancer cells that had spread before surgery or ovarian tissue that remains. Its patient guidance on ovarian, fallopian tube, and primary peritoneal cancer prevention explains that surgery reduces risk rather than eliminating every possibility.

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How much does risk-reducing surgery lower risk?

The clearest figure in the cited evidence applies to a specific group: the NCI’s professional prevention summary reports a 90% reduction in ovarian cancer risk observed among women with a BRCA1 or BRCA2 mutation who had risk-reducing bilateral salpingo-oophorectomy. The NCI does not state a year for that figure on its professional prevention PDQ. It is not an estimate for every patient, and it does not mean an individual’s risk becomes zero.

A separate NCI summary describes a family-based BRCA study: 2 of 259 women (0.8%) who had prophylactic bilateral oophorectomy later developed papillary serous peritoneal carcinoma, while 6 of 259 (2.8%) had stage I ovarian cancer identified at surgery. Matched controls had a 20% ovarian cancer occurrence, and surgery was associated with a risk reduction exceeding 90% over an average follow-up of nine years. These are results from that particular cohort, not a personal forecast; the NCI cautions that family-based studies can have selection and other biases. See the NCI’s professional treatment PDQ.

ACOG also cites an observational Swedish study reporting 65% lower ovarian cancer risk after bilateral salpingectomy and 28% lower risk after sterilization, compared with the study’s reference group. Those figures concern different procedures and a particular study; they are not estimates of the effect of removing both ovaries and tubes. ACOG reports them in its 2019 Committee Opinion.

Eight evidence-based clarifications about ovarian cancer risk

1. Does removing both ovaries guarantee you will never develop a related cancer?

No. Primary peritoneal cancer can still occur after risk-reducing surgery. The operation lowers risk; it does not remove the peritoneum or guarantee that no cancer cells were present elsewhere.

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2. Do all ovarian cancers start in an ovary?

No. Many high-grade serous cancers are thought to originate in the fallopian tube. Other ovarian cancers, including some nonepithelial cancers, can arise in the ovary. The site of origin matters when discussing which structures an operation removes.

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3. Is ovary removal the same as removing the ovaries and tubes?

No. Oophorectomy removes ovaries; salpingectomy removes fallopian tubes; salpingo-oophorectomy removes both. An operation’s risk-reduction implications depend on what is removed and why it is being considered.

4. Does the BRCA risk-reduction figure apply to everyone?

No. The NCI’s reported 90% reduction applies to women with a BRCA1 or BRCA2 mutation who had risk-reducing bilateral salpingo-oophorectomy. It should not be applied to people at average risk or treated as an individual guarantee.

5. Is risk-reducing surgery the same as surgery to treat diagnosed cancer?

No. Risk-reducing surgery is considered for someone who does not have diagnosed cancer, often because of inherited risk. Surgery for a diagnosed cancer is treatment and follows a different clinical decision process.

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6. Does surgery before natural menopause have no wider health effects?

No. Removing both ovaries before natural menopause causes immediate menopause. Symptoms and longer-term concerns, including effects on bone and cardiovascular health, should be part of a clinician-guided discussion. ACOG and NCI describe these considerations in their patient information on ovarian cancer and NCI prevention guidance.

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7. Can CA-125 blood tests or transvaginal ultrasound guarantee early detection?

No. For average-risk women, ACOG says these tests have not been shown to reduce mortality when used for screening and can lead to harms from false-positive results. Screening is not a substitute for an individualized risk assessment. See ACOG’s guidance on early detection of epithelial ovarian cancer.

8. Is one operation right for everyone concerned about ovarian cancer?

No. Age, menopause status, genetic findings, personal and family history, and the circumstances of surgery all matter. A general article cannot determine which operation, if any, is appropriate for an individual.

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What should someone weighing risk-reducing surgery discuss?

  • Risk context: whether a pathogenic inherited variant or family history changes estimated risk, and whether genetic counseling is appropriate.
  • Exact operation: whether the proposed procedure removes ovaries, tubes, or both, and what that means for the cancers being considered.
  • Timing and menopause: likely effects of the timing of surgery, including menopause symptoms and longer-term health considerations if surgery occurs before natural menopause.
  • Remaining risk: what residual peritoneal cancer risk means in the person’s circumstances and what follow-up is appropriate.
  • Purpose: whether the discussion concerns prevention in someone without a diagnosis or treatment of an existing cancer.

People with a known pathogenic variant, a concerning family history, symptoms, or a decision about surgery should discuss their situation with a clinician experienced in hereditary cancer risk or gynecologic oncology. The evidence summarized here is general guidance, not individualized medical advice.

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