Objectives Exposure to air pollution has destructive health consequences and a potential role in ovarian cancer etiology. We conducted a systematic review of the studies assessing the associations between ovarian malignancy and exposure to air pollutants. Content The included studies were categorized based on types of measured ambient air pollutants, including particulate matter (five studies), gases (two studies), air pollutant mixtures (eight studies), and traffic indicators for air pollution (only one study). Because of the heterogeneity of quantitative data of the reviewed studies, we qualitatively reviewed the air pollution role in ovarian cancer risk with representing incidence and/or the mortality rate of ovarian cancer in related with air pollution. Nine studies were ecological study design. Except for one, all studies confirmed a positive correlation between exposure to ambient air pollution (AAP) and increased ovarian cancer risks. Summary We concluded that prolonged air pollution exposure through possible mechanisms, estrogen-like effects, and genetic mutations might affect ovarian tumorigenesis. This research surveyed the limitations of the previous studies, including issues with ambient air pollution surveillance and assessing the exposure, determining the air pollution sources, data analysis approaches, and study designs. Outlook Finally, the authors provide suggestions for future environmental epidemiological inquiries on the impact of exposure to ambient air pollution on ovarian malignancy.

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