Clinical recommendation	Evidence rating	References
The USPSTF recommends against routine screening for ovarian cancer.	A	11, 14, 38
The USPSTF recommends against routine referral for genetic counseling or routine BRCA testing in women whose family history is not associated with an increased risk of deleterious mutations in BRCA1 or BRCA2 genes.	A	11, 14, 38
The USPSTF recommends genetic counseling and evaluation for BRCA testing in women whose family history is associated with an increased risk of deleterious mutations in BRCA1 or BRCA2 genes.	A	11, 14, 38
Prophylactic bilateral salpingo-oophorectomy should be considered in women with a mutation in the BRCA1 or BRCA2 gene, or hereditary nonpolyposis colorectal cancer syndrome (i.e., Lynch II syndrome).	C	40, 41
For patients with hereditary nonpolyposis colorectal cancer syndrome or hereditary breast and ovarian cancer syndrome who choose not to undergo prophylactic bilateral salpingo-oophorectomy, the National Comprehensive Cancer Network recommends transvaginal ultrasonography and CA 125 measurement every six months during days 1 through 10 of the menstrual cycle. This should begin at 35 years of age, or five to 10 years earlier than the earliest age of diagnosis of ovarian cancer in the family.	C	43, 44