A 55-year-old Hispanic woman presents for her annual gynecologic exam. Her menarche was at age 12 and her menopause was at 52. She is concerned about her risk of ovarian cancer because her mother was diagnosed with ovarian cancer at age 60, and her older sister was recently diagnosed with breast cancer associated with a BRCA1 mutation. She smokes one pack of cigarettes every day. She is eager to understand which of her risk factors is most significant for developing ovarian cancer. Question: The most significant risk factor for developing ovarian cancer is:
