A 57-year-old woman comes in for her annual well-woman exam, expressing concerns about her risk of ovarian cancer. She has a strong family history of ovarian cancer—both her mother and sister were diagnosed in their 50s. Her personal history includes menarche at age 11 and menopause at age 53. She smokes one pack of cigarettes daily and has a BMI of 32. Given her concerns and family history, she asks which of her risk factors most strongly predisposes her to ovarian cancer. Question: Which of the following is the strongest risk factor for ovarian cancer in this patient?
