NHS Ovarian Cancer Genetic Testing: Who Qualifies?

If your mum, sister, grandmother or aunt has had ovarian cancer, you might have wondered whether it could run in your family.

And could you have genetic testing on the NHS to find out?

The good news is that NHS guidance has changed. You may now qualify for a genetics referral even if only one close relative has had ovarian cancer.

But being referred doesn’t always mean you’ll be offered a genetic test.

In this guide, I’ll explain who may qualify, what happens after a referral and, importantly, what you can do if an inherited cancer risk is found.

Can ovarian cancer be inherited?

Yes. Although most ovarian cancers aren’t caused by an inherited gene change, around one in five people diagnosed with epithelial ovarian cancer may carry an inherited genetic change that contributed to their risk, with estimates varying between studies and cancer subtypes.

The best-known genes are BRCA1 and BRCA2, but several others can also increase ovarian cancer risk, including RAD51C, RAD51D, BRIP1 and PALB2. Certain genes associated with Lynch syndrome are also relevant.

Some of these genes are linked to more than one cancer.

For example, BRCA genes can increase the risk of breast, ovarian, prostate and pancreatic cancer. This is why a family history of different cancers may be important, even when nobody else in the family has had ovarian cancer.

Inherited cancer-risk genes can come from either your mum or your dad. And a parent doesn’t need to have had cancer to pass a genetic change on to their children.

Does one relative with ovarian cancer qualify you for NHS testing?

Under NICE guidance published in 2024, having just one first- or second-degree relative with ovarian cancer can be enough to ask for a referral to NHS genetics services.

This includes:

• A first-degree relative: Your mum, sister, daughter, dad, brother or son. In practice, a diagnosis of ovarian cancer in your mother, sister or daughter is the relevant example.
• A second-degree relative: Your grandmother, aunt, half-sister or niece, including relatives on your dad’s side of the family.

For example, if your paternal grandmother had ovarian cancer, that family history may be enough to justify asking your GP for a genetics referral.

But there is an important difference between qualifying for a referral and qualifying for genetic testing.

A referral means a specialist can look at your personal and family history in more detail. They will then decide whether testing is appropriate under NHS criteria.

So having one relative with ovarian cancer doesn’t automatically guarantee you’ll receive a test.

If your relative is still alive, it may be more useful for them to have genetic testing first. This is because testing someone who has already had cancer can sometimes give the whole family a clearer answer.

Can you qualify for NHS genetic testing without a family history?

Yes. And this is an important point because family history alone doesn’t identify everyone who carries an inherited cancer-risk gene.

Some families are small, people may not know their relatives’ medical histories, or the gene may have been passed down through several people who never developed cancer.

There are also certain populations in which inherited BRCA gene changes are more common.

Jewish ancestry and inherited BRCA risk

People with Ashkenazi Jewish ancestry have a substantially higher chance of carrying an inherited BRCA1 or BRCA2 gene change than the general UK population.

Approximately 1 in 40 people with Ashkenazi Jewish ancestry carry a BRCA gene change, compared with around 1 in 250 people in the general UK population.

Risk is also higher in some other Jewish populations, including people with Sephardi Jewish ancestry.

NICE recommends offering referral for genetic counselling and testing for certain higher-risk ancestry groups, even without a personal or family history of cancer. These include people with at least one Ashkenazi Jewish or Sephardi Jewish grandparent.

What happened to the NHS Jewish BRCA Testing Programme?

The NHS Jewish BRCA Testing Programme offered free BRCA testing to eligible adults with Jewish ancestry in England, even without a family history of cancer.

The original programme is now closed to new registrations, but NHS England is working towards establishing a longer-term service, anticipated in 2027.

You can register your interest and check for updates on the NHS Jewish BRCA Testing Programme website.

If you have Jewish ancestry alongside a personal or family history of breast, ovarian or prostate cancer, you may still be eligible for testing through another NHS pathway. You don’t necessarily need to wait for the programme to reopen.

New BRCA testing for people with Orkney and Shetland ancestry

Researchers have discovered that certain inherited BRCA gene changes are more common in people with ancestry from Westray in Orkney and Whalsay in Shetland.

A new NHS-supported genetic testing programme is due to begin in 2027, initially in Orkney, before expanding to Shetland and other parts of Scotland.

The programme will offer testing for specific BRCA1 and BRCA2 gene changes associated with increased risks of breast, ovarian and other cancers. People living in Scotland with at least one grandparent from Westray or Whalsay are expected to be eligible, even without a family history of cancer.

This is another important example of why relying on family history alone can miss people with inherited cancer risk.

If you have ancestry from these islands, you can follow updates through the Viking Genes project or your local NHS health board.

Why might genetics services not offer a test after referral?

This is understandably confusing. You might be referred because your mum or grandmother had ovarian cancer, but then be told that you don’t meet the criteria for NHS genetic testing.

That doesn’t mean your family history isn’t important.

NHS genetics services use your personal and family history to estimate how likely you are to carry an inherited cancer-risk gene.

Traditionally, testing was generally offered when that probability was at least 10%. However, updated NICE guidance published in 2024 recommends lower thresholds for some people, depending on their age and sex. For example, it recommends testing at a probability of 2% or more for women aged 30–49 in certain circumstances.

These recommendations have not always been fully reflected in NHS testing pathways, so access can vary.

Not meeting the criteria for NHS testing doesn’t mean you have no inherited cancer risk. It means you haven’t met the eligibility requirements for testing through that particular pathway.

What should I ask my GP?

If ovarian cancer has affected someone in your family, it’s worth talking to your GP, even if it’s only one relative.

You don’t need to know the names of genes or genetic syndromes before asking for help.

You could simply say:

“My mum/sister/grandmother/aunt had ovarian cancer, and I’m wondering whether there could be an inherited risk in our family. Would it be worth referring me to an NHS genetics service?”

Before your appointment, try to find out:

• Which relative had ovarian cancer and how old they were when diagnosed.
• Whether anyone else in the family has had breast, prostate, pancreatic or bowel cancer.
• Whether the cancers were on your mum’s or dad’s side of the family.
• Whether your relative has already had genetic testing, and what the result was.
• Whether there is a known BRCA or other inherited cancer-risk gene change in your family.

Don’t worry if you can’t find out everything. You can still ask for advice with the information you have.

If a relative has already been diagnosed with ovarian cancer, it’s worth asking whether they were offered inherited genetic testing as part of their cancer care.

You can also read our guide to gathering your family history of cancer.

What if an inherited ovarian cancer risk is found?

Finding out that you carry an inherited cancer-risk gene can feel overwhelming. But it can also give you opportunities to reduce your risk that you might not otherwise have known about.

What happens next depends on the gene involved, your age, family history and personal circumstances.

Understanding your individual risk

Not everyone with an inherited gene change has the same level of cancer risk.

For example, BRCA1 and BRCA2 can significantly increase ovarian cancer risk, while other genes are associated with smaller increases.

A specialist can help you understand your estimated lifetime risk and what that means for you.

Risk-reducing surgery

For people at sufficiently increased risk, surgery to remove the ovaries and fallopian tubes can substantially reduce the risk of ovarian cancer.

The right timing depends on which gene is affected, whether you’ve completed your family and other health considerations.

Removing the ovaries before natural menopause causes an immediate menopause, so the benefits and longer-term implications need careful discussion.

Some women may also need to consider risk-reducing surgery for other cancers, depending on their genetic results.

Research into alternatives to early menopause

Researchers are investigating whether removing the fallopian tubes first, and delaying removal of the ovaries, might offer a way to reduce ovarian cancer risk while avoiding immediate surgical menopause.

The UK PROTECTOR study has investigated this approach in women at increased inherited risk.

This is an important area of research, but removing the fallopian tubes alone has not yet been established as providing the same cancer protection as removing both the tubes and ovaries.

The PROTECTOR trial is currently listed as on hold for recruitment. You can read about the PROTECTOR study and its approach.

What about ovarian cancer screening?

For women at higher inherited risk of ovarian cancer, there are now some additional screening options.

In 2024, NICE recommended that certain women with inherited cancer-risk gene changes who aren’t ready to have risk-reducing surgery may be offered regular ovarian cancer surveillance.

This involves a CA125 blood test every four months, with the results analysed using a special algorithm, such as the Risk of Ovarian Cancer Algorithm (ROCA). Rather than looking at one CA125 result in isolation, this approach looks at how levels change over time.

Studies suggest that this type of surveillance can help detect ovarian cancer at an earlier stage, when treatment may be more effective. However, it hasn’t yet been shown to improve survival.

Surveillance is considered for selected women with inherited changes in genes such as BRCA1, BRCA2, RAD51C, RAD51D, BRIP1 and PALB2, depending on their age and individual circumstances.

Not every NHS hospital currently offers this surveillance programme. NICE has recognised that specialist services and systems need to be developed to deliver it consistently.

It’s also important to understand that screening doesn’t prevent ovarian cancer and isn’t a replacement for risk-reducing surgery, which remains the most effective way to reduce the risk for women with significantly increased inherited risk.

If you have an inherited ovarian cancer-risk gene and aren’t ready to consider surgery, it’s worth asking your genetics or gynaecology team whether specialist ovarian surveillance is available to you.

Screening for other cancers

Many genes associated with ovarian cancer can also increase the risk of other cancers, particularly breast cancer.

Depending on your results, you might qualify for additional screening, such as breast MRI scans, or advice about other ways to reduce your risk.

What about your family?

If an inherited genetic change is identified, your adult relatives may also be able to have testing for that same change.

This can help relatives who carry it access appropriate screening and prevention, while reassuring those who haven’t inherited the family’s identified genetic change.

Knowing about an inherited risk doesn’t mean you’ll develop cancer. It means you have more information to make choices about your health.

Genetic testing referrals for healthcare professionals

If you’re a gynaecologist, fertility specialist, breast surgeon, oncologist or other healthcare professional caring for patients concerned about inherited ovarian cancer risk, we can help.

We know that family history alone doesn’t identify everyone who carries an inherited cancer-risk gene. Some patients may not meet NHS or insurance criteria for testing, while others may wish to explore their risk even without a strong family history.

At Coyne Medical, we already work with consultants who want to make genetic testing part of the care they offer their patients.

Our comprehensive 36-gene inherited cancer panel includes BRCA1, BRCA2, BRIP1, RAD51C, RAD51D and PALB2, alongside genes associated with Lynch syndrome and other inherited cancer risks.

Every patient has a doctor consultation before testing and a scheduled follow-up appointment, whether their result is positive or negative.

We can help patients understand their results, discuss cancer prevention and coordinate appropriate NHS or private specialist referrals. With the patient’s consent, we can also share results and recommendations with their referring clinician.

We work alongside you, helping you offer your patients more comprehensive preventative care.

What should you do if ovarian cancer runs in your family?

If your mum, sister, grandmother or another relative has had ovarian cancer, it’s worth finding out whether there could be an inherited risk.

Start by checking who may qualify for NHS genetic testing.

You can also use our family history of cancer guide to help gather the information your GP may need.

But remember, you don’t need a family history of cancer to carry an inherited cancer-risk gene.

Finding risk earlier creates choices

At Coyne Medical, we believe that understanding your inherited cancer risk can help you make more informed decisions about your future health.

Our doctor-led 36-gene inherited cancer panel includes genes associated with ovarian cancer, with consultations before and after testing to help you understand your results.

We’ll discuss what your findings mean, whether there are ways to reduce your risk, and what additional screening or specialist referrals might be appropriate.

Even if no inherited genetic change is found, we’ll consider your family history and what it may mean for your future health.

Clinical references

NICE NG241: https://www.nice.org.uk/guidance/ng241/chapter/recommendations

NHS Genomic Test Directory: https://www.england.nhs.uk/publication/national-genomic-test-directories/

Information prepared 28 October 2026. This page is for general information, not personal medical advice or a consultation. Discuss your family history, personal screening and medical decisions with your own doctor or healthcare team. NHS pathways and criteria may change and differ across UK nations.