Ovarian cancer can develop at any age, including childhood, but it is rare in young women. The median age at diagnosis is 63, and most cases develop after menopause. Only about 1.5% of ovarian cancers are diagnosed in girls and women under 20, while nearly half of all cases occur in women 63 and older. That said, the type of ovarian cancer that develops varies significantly by age, which is why younger women are not completely in the clear.
How Risk Changes by Age
Federal cancer surveillance data breaks down the percentage of new ovarian cancer cases by age group, and the pattern is striking. Among women under 20, only 1.5% of cases occur. Between ages 20 and 34, that rises slightly to 4.9%. The 35 to 44 range accounts for 7.9% of diagnoses. Risk begins climbing more steeply in the mid-40s: women aged 45 to 54 represent 15.6% of cases, while the two peak decades, 55 to 64 and 65 to 74, each account for 23.9%. After 75, the share begins to drop, with 15.7% of cases in the 75 to 84 group and 6.4% in women over 84.
In practical terms, ovarian cancer is uncommon before 40 and becomes increasingly likely as you approach and pass menopause. Starting menopause after age 52 is itself a factor that modestly raises risk. But “uncommon” in younger women is not the same as impossible, and about 14% of all ovarian cancers are diagnosed in women under 45.
Different Types Strike at Different Ages
The ovaries contain several cell types, and the cancer that arises from each one tends to appear at a different stage of life. Understanding this helps explain why a teenager and a 65-year-old can both be diagnosed with “ovarian cancer” yet have very different diseases.
Epithelial Tumors
These cancers start in the cells covering the outside of the ovary and account for the vast majority of cases, especially in older women. The most common and aggressive subtype, high-grade serous carcinoma, occurs most often in women between 40 and 60. Clear cell and mucinous subtypes mainly affect women over 50. Because epithelial cancers dominate the overall statistics, they are the reason the median diagnosis age skews into the 60s.
Germ Cell Tumors
These are the ovarian cancers most likely to affect young women and girls. Germ cell tumors develop from the egg-producing cells and typically appear in teens through the early 30s. One subtype, immature teratomas, is most common in teenage girls and women in their early 20s. Another, dysgerminomas, affects women aged 15 to 45. Among girls aged 15 to 19, germ cell tumors are the single most common type of malignant ovarian tumor. While these cancers are relatively rare overall, they are the main reason ovarian cancer appears on the radar for younger women at all.
Stromal Tumors
Sex-cord stromal tumors are uncommon and arise from the connective tissue of the ovary. One form, juvenile granulosa cell tumors, can appear in children and young women. Another, Sertoli-Leydig tumors, is most common in women in their 20s and 30s. Adult granulosa cell tumors tend to occur around the time of menopause.
How Genetic Mutations Shift the Timeline
Inherited gene mutations can move the typical age of diagnosis forward by years or even decades. Women who carry a BRCA1 mutation are diagnosed at a median age of about 46.5, roughly 20 years younger than non-carriers (whose median is nearly 67). BRCA1 carriers also face a lifetime risk of 40 to 60% by age 80, compared to roughly 1 to 2% in the general population.
BRCA2 mutations carry a lower but still significant lifetime risk of 11 to 27%, and the median age at diagnosis for BRCA2 carriers is closer to 64, not dramatically different from the general population. Other gene mutations, including BRIP1, RAD51C, and RAD51D, also raise ovarian cancer risk, though to a lesser degree than BRCA1.
Because BRCA1 can trigger cancer so much earlier, medical guidelines recommend that BRCA1 carriers consider preventive removal of the ovaries and fallopian tubes between ages 35 and 40. For BRCA2 carriers, that window extends to 40 to 45 because of the later typical onset. Carriers of BRIP1, RAD51C, or RAD51D are generally advised to consider the procedure between 45 and 50. In the interim, some high-risk women undergo monitoring with ultrasound or blood tests starting at age 30 to 35.
Why Younger Women Are Often Diagnosed Later
There is no reliable routine screening test for ovarian cancer in the general population. Symptoms like bloating, pelvic pain, feeling full quickly, and changes in urination are vague enough that they overlap with dozens of common conditions. In younger women, these symptoms are even less likely to prompt suspicion of ovarian cancer because the disease is statistically uncommon before menopause. The result is that younger patients sometimes experience longer delays between first symptoms and diagnosis.
The upside is that younger women who are diagnosed tend to have better outcomes. Women under 45 have a five-year survival rate around 71%, while women 75 and older survive at much lower rates. Part of this gap is biology: the germ cell tumors that predominate in younger patients respond well to treatment and are often caught at an earlier stage. Part of it is that younger patients generally tolerate aggressive treatment better.
Factors That Raise or Lower Risk at Any Age
Beyond age and genetics, several factors influence ovarian cancer risk. Having never been pregnant, starting periods early, or reaching menopause late all slightly increase risk because they result in more total ovulation cycles over a lifetime. Hormone replacement therapy used after menopause, particularly estrogen-only formulations taken for several years, has been linked to increased risk as well.
Factors that lower risk include having used oral contraceptives (the longer the use, the greater the protection), having had one or more pregnancies, and breastfeeding. Tubal ligation and removal of the fallopian tubes also appear to be protective, possibly because many ovarian cancers actually originate in the fallopian tubes rather than the ovary itself.
If you have a strong family history of ovarian or breast cancer, genetic counseling can clarify whether you carry a mutation that changes your risk timeline. For everyone else, awareness of persistent, unexplained symptoms is the most practical tool available, regardless of age.