89 Recent research published in Nature Reviews Clinical Oncology provides a comprehensive analysis of the global epidemiology of epithelial ovarian cancer. The study, led by Penelope M. Webb and Susan J. Jordan, highlights significant trends in incidence and mortality rates, underscores key risk factors, and suggests potential preventive measures for this complex and heterogeneous disease. Epithelial ovarian cancer is the eighth most common cancer among women globally, accounting for 3.7% of cancer cases and 4.7% of cancer deaths in 2020. Historically, the highest age-standardised incidence rates were observed in northern Europe and North America. However, these regions have recently seen a decline in incidence. This decrease is partly attributed to improved detection methods and changes in diagnostic coding practices. Many high-grade serous ovarian carcinomas, previously classified as ovarian cancers, are now recognised to originate from the fimbrial ends of the fallopian tubes. Consequently, they are increasingly coded as fallopian tube cancers, contributing to the apparent decline in ovarian cancer cases. In contrast, incidence rates are rising in parts of eastern Europe and Asia. This trend is linked to changes in reproductive behaviours, lifestyle factors, and possibly, delayed implementation of preventive healthcare measures. The study emphasises the importance of understanding regional differences to develop targeted interventions. Epithelial ovarian cancer comprises five major clinically and genetically distinct histotypes: high-grade serous, low-grade serous, endometrioid, clear cell, and mucinous carcinomas. Each histotype exhibits unique epidemiological patterns and risk factors. For instance, most high-grade serous carcinomas are now believed to arise in the fallopian tubes, while other histotypes may originate from different anatomical sites within the pelvis. The study identifies several reproductive and hormonal factors that influence the risk of developing epithelial ovarian cancer. Protective factors include oral contraceptive use and tubal sterilisation, both of which significantly reduce the risk. In contrast, factors such as hormone replacement therapy during menopause and certain reproductive history variables, like early menarche and late menopause, increase the risk. Other important risk factors include genetic predisposition, with mutations in BRCA1 and BRCA2 genes significantly elevating the risk. Lifestyle-related factors, such as obesity, smoking, and lack of physical activity, also contribute to the overall risk profile. Additionally, the study highlights the potential impact of environmental exposures, like talcum powder use, although the evidence remains inconclusive. Given the complex interplay of risk factors, the study advocates for a multifaceted approach to prevention. One promising strategy is opportunistic salpingectomy—the removal of fallopian tubes during routine gynaecological surgeries. This procedure could significantly reduce the incidence of high-grade serous carcinomas, which are now thought to originate in the fallopian tubes. Moreover, the researchers suggest that raising awareness about reproductive and lifestyle choices can empower women to make informed decisions that may lower their cancer risk. Population-based genetic testing for BRCA mutations is another crucial preventive measure. Identifying carriers of these mutations enables targeted surveillance and early intervention, potentially reducing mortality rates. Furthermore, the study calls for the implementation of national and regional screening programmes to ensure equitable access to preventive care and early diagnosis. The findings underscore the need for ongoing research to refine our understanding of ovarian cancer epidemiology and improve preventive strategies. Future studies should focus on the biological mechanisms underlying the different histotypes and the development of more effective screening tools. Additionally, the researchers highlight the importance of global collaboration to address the rising incidence in less developed regions and to share successful prevention and treatment strategies.