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Genetic testing and testing for , ovarian and primary peritoneal cancer

This section covers the following topics:

Genetic tests for inherited mutations for treatment selection

All people diagnosed with ovarian cancer should be offered genetic testing for an . Genetic test results  may be used to guide treatment selection for people diagnosed with ovarian cancer.  

  • People with advanced ovarian cancer who test positive for an inherited or mutation may benefit from treatment with a type of known as a .
  • People who test positive for other inherited gene mutations may qualify for clinical trials looking at targeted therapies to treat hereditary ovarian cancer. 
  • People who test positive for a gene mutation may benefit from treatment with an agent. 


tests look at samples of blood, tumor or other tissue for changes or abnormalities caused by cancer. These tests can give doctors clues about the cancer, including:

  • how fast the cancer is growing
  • which treatments are most likely to work
  • whether or not the cancer is responding to treatment or growing
  • whether or not the cancer has come back after remission

tests may be used to select treatments, and help patients avoid side effects from treatments that will not work for them. tests used to select a specific treatment are sometimes called companion diagnostic tests. These tests may be done on tumor tissue or (in many cases) on blood. See our Testing section for more information. 

Biomarkers for treatment selection

Examples of tests used in , ovarian and primary peritoneal cancer include:

  • Tests can be done to look for  or gene mutations in the tumor. Women who test positive for a or mutation in their tumor may benefit from a type of therapy known as a . A tumor test positive for a  or mutation in one of two situations:, 
    • when women who have an in or develop ovarian cancer, their tumor is very likely to display the same mutation.
    • women who test negative for an in or may still develop an acquired  mutation in their tumor. Women with a mutation in their tumor may also respond well to treatment.  
  • A tumor test for a marker called  () can help women with advanced ovarian cancer learn if they may benefit from with a .  
  • Some ovarian cancers will have an abnormality known as (“ high") also known as "" ( or ). cancers are common in people with a gene mutation. These cancers may respond well to a type of treatment known as an immune checkpoint inhibitor. One example of an agent used for MSI-H cancers is Keytruda (pembrolizumab).

Biomarkers to monitor recurrence or response to treatment

CA125 is a type of protein that is produced in large amounts by some ovarian cancers. Doctors may use CA125 blood tests monitor recurrence or response to treatment. 

Clinical trials are studying whether other blood tests known as liquid biopsies can be used to detect recurrence in people who have completed treatment for ovarian cancer.  These tests check the blood for abnormal from tumor cells (known as circulating tumor or ).

Last updated January 04, 2024

Paying For Care
Paying For Care

Paying for testing

Insurance companies are required to cover the costs for cancer treatment. Health plans may vary on the amount of out-of-pocket costs and coverage for specific doctors, facilities, tests or treatments. Your doctor's office and treating hospital should disclose how much your treatment may cost you and work with you on a plan to cover the cost of your care.

Medicare will cover the cost for genetic testing and testing for people who meet certain criteria. Medicare coverage varies based on where you live. Visit this site to find and contact your regional Medicare provider for more information about coverage. The Medicaid website has a link to state Medicaid programs, which list specific eligibility for each state.

If you need information about finding an insurance plan, watch our video: Choosing Wisely: How to Pick Insurance Plans.Visit our Health Insurance Appeals page for additional information on insurance appeals. 

Some laboratories have assistance programs that help cover the cost for tumor testing: 

Organizations that offer co-pay assistance:

Other resources:

  • The American Cancer Society provides information and resources on covering the cost of cancer care. Public assistance, such as Medicaid may be available if you are ineligible for other programs. 
  • Triage Cancer offers tools and resources to help individuals cope with the financial aspects of a cancer diagnosis.

updated: 05/20/2023

Paying For Care
Paying For Care

Insurance coverage for genetic counseling and testing

Most health plans cover genetic counseling and testing for inherited gene mutations linked to cancer in people who meet the national guidelines. The cost of testing and your out-of-pocket charges may vary based on several factors.

People who are denied coverage for genetic testing can file an appeal (FORCE has sample appeal letters). Your healthcare provider can work with your insurance company and help you file an appeal if needed. Low cost testing may be available for $250 or less. Learn more about coverage for genetic counseling and testing here

If you need information about finding an insurance plan, watch our video: Choosing Wisely: How to Pick Insurance Plans.

testing under the Affordable Care Act

Under the Affordable Care Act (ACA), insurance companies must pay for both genetic counseling and  testing with no out-of-pocket costs for women who meet certain criteria. The ACA regulations are limited to testing for and only and do not cover genetic counseling or testing in all situations. You can learn more about testing under the ACA here

Medicare and Medicaid coverage of genetic testing

Genetic counseling and testing is typically covered by Medicare for people already diagnosed with cancer who are in treatment or for whom test results may affect their care. Most state Medicaid programs cover genetic testing for and mutations for people who meet requirements, which vary by state. You can read more about Medicare and Medicaid coverage of genetic testing here.

Financial assistance or low cost genetic testing

JScreen is a national program based out of Emory University that provides low-cost at-home genetic counseling and testing with financial assistance available. Many laboratories offer low-cost genetic testing or financial assistance programs. Programs vary, so if you are not eligible for assistance through one lab, consider contacting other labs to see if you qualify .   

updated: 03/16/2023