**13. Current UK standards for testing ovarian cancer genetics**

According to current British Gynaecological Cancer Society guidelines for testing ovarian cancer genetics,

Women with High grade serous ovarian cancer or G3 endometrioid ovarian adenocarcinoma have >10% risk of an underlying BRCA mutation should be offered clinical genetics counselling and testing. (GRADE C) Recently it has been shown that ~18% (much higher in certain groups such as Ashkenazi Jews) of the population of women presenting with high grade serous or G3 endometrioid ovarian adenocarcinoma carry a germline BRCA mutation, 44% of whom have no positive family history. Every patient with a current or past histological diagnosis of HGSC or G3 endometrioid ovarian carcinoma therefore qualifies for BRCA counselling and testing, as advised by National institute for Health and Care Excellence, which should be discussed and offered.

The above guidelines and standards are supported by the evidence from the GTEOC (Genetic Testing in Epithelial Ovarian Cancer) [24] study in which the primary objective of the study was to determine the feasibility, acceptability and cost-effectiveness of screening all newly diagnosed women with EOC for *BRCA1/ BRCA2* mutations by determining the mutation prevalence, calculating the cost for each gene mutation detected and assessing the psychological impact based on questionnaire responses and qualitative interviews.

This study has shown the mutation yield in unselected women diagnosed with EOC from a heterogeneous population with no founder mutations was 8% in all ages and 12% in women under 70 [25]. Unselected genetic testing in women with EOC was acceptable to patients and is potentially less resource intensive.
