Postmenopausal women living in a high radon zone have significantly higher risks for ovarian cancer incidence and mortality, according to a study published online April 10 in JAMA Network Open.
Mark R. Williamson, Ph.D., from the University of North Dakota in Grand Forks, and colleagues conducted a prospective cohort study to examine whether higher home radon levels are associated with an increased risk for ovarian cancer. Postmenopausal women aged 50 to 79 years were enrolled, and outcomes were followed for 31 years.
The researchers observed 1,645 incident ovarian cancers and 1,048 ovarian cancer deaths during a mean follow-up of 17.7 years among the 127,547 women with available radon zone values. The hazard ratio (HR) for all ovarian cancers was not significantly higher for women living in the medium radon zone versus the low radon zone (1.13; 95 percent confidence interval [CI], 1.00 to 1.29), after adjustment for covariates. However, women living in the high radon zone versus the low radon zone had a significantly higher HR (1.31; 95 percent CI, 1.11 to 1.54). For the most common histologic type, serous ovarian cancer, similar findings were observed, with the HR significantly higher in the high zone (1.38; 95 percent CI, 1.09 to 1.74), but not in the medium zone (1.06; 95 percent CI, 0.88 to 1.27). Significantly higher ovarian cancer mortality was also seen in the high versus the low radon zone (HR, 1.31; 95 percent CI, 1.07 to 1.60). Similar results were seen in sensitivity analyses using three alternate radon measures.
“The biggest takeaway is that this study is really the first to report that environmental radon exposure, which is a fairly common environmental hazard, can lead to an increased risk of ovarian cancer in women,” Jaqueline Moline, M.D., from Northwell Health, said in a statement.
Research shows that Black women face significantly poorer ovarian cancer outcomes despite having lower incidence rates than white women. Studies consistently show that Black patients are more likely to be diagnosed at later stages, experience treatment delays, and face barriers to guideline-concordant care.
Although socioeconomic inequities and healthcare access are primary contributors to these disparities, environmental conditions may also serve as a “hidden” contributor.
The study’s findings link residential radon exposure to an increased ovarian cancer incidence and mortality, which can be particularly relevant for clinicians caring for patients in historically underserved communities. Housing inequities, geographic location, and limited access to environmental testing and mitigation resources often shape exposure to environmental carcinogens.
Providers must consider how environmental health screening may fit into broader conversations around cancer prevention and social determinants of health — particularly for postmenopausal Black women, who already face elevated barriers to timely gynecologic evaluation and care.
Radon is odorless and invisible, so that patients can be unaware of their possible risk. For providers practicing in high-radon communities, they can incorporate basic education on environmental exposure into preventive care — especially for older adults and patients with multiple cancer risk factors.
While standard ovarian cancer screening recommendations remain unchanged, the study underscores the need for symptom vigilance and risk assessment. Clinicians should encourage patients to report persistent bloating, pelvic or abdominal pain, early satiety, and urinary symptoms that could require further evaluation.
For Black patients in particular, culturally responsive communication and trust-building remain critical. Studies have shown that Black women’s symptoms are often dismissed or minimized by providers, which contributes to delayed diagnosis and poorer outcomes.
At a systems level, preventive care can involve:
More research is needed to establish causality, but the study’s findings highlight how environmental health and cancer equity intersect — and why clinicians may need to have broader conversations about ovarian cancer risks beyond genetics and reproductive history.
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