In the general population, the lifetime risk of epithelial ovarian cancer (OC) is 1.1%.1 The low prevalence of this disease as well as the lack of a clinically identifiable precursor lesion make OC a disease that has stymied attempts at screening and early detection. One way to improve early detection is to consider a population with a higher prevalence of disease, such as patients who carry a germline pathogenic variant (PV) in BRCA1/2. While some studies have shown a potential stage shift in this highest-risk population, there is no clear impact on OC mortality, and routine screening is not recommended. As a result, surgical removal of the ovaries and fallopian tubes has historically been the most effective method of risk reduction, although not entirely, and primarily in high-grade serous (HGS) disease. Thus, there is value in identifying other high-risk populations who may be targeted for more effective screening, prevention, or both.