评估上皮性卵巢癌（EOC）患者中与祖传致病性/可能致病性变异（PVs）和遗传咨询有关的血统率。纳入从2015年1月1日至2020年12月31日期间進行临床腫瘤-正常测序的病理确认的EOC患者，包括对≥76基因的基因组分析。对于新识别的PVs，患者被转介给临床遗传学服务（CGS）接受咨询。使用自述种族/族裔和Ashkenazi犹太人（AJ）渊源来定义族群。使用经过验证的算法进行计算推断遗传血统。建立了逻辑回归模型。在1,266名患者中，自述血统（AJ，17％；亚洲人，10％；黑人/非裔美国人，5.4％；西班牙裔，6.2％；非西班牙裔白人，57％；其他，0.16％；未知，4.0％）与遗传血统相关（AJ渊源，18％；混合血统，10％；非洲血统，4％；东亚人（EAS），6％；欧洲人，56％；美洲原住民，0.2％；南亚人（SAS），4％；未知，2％）。313名患者（25％）观察到了基因组PVs，其中195名患者（15％）在EOC相关基因中观察到了PVs。PV患者在诊断时年龄较轻（59岁对62岁；P < .001），且更有可能患高级浆液性卵巢癌（83％对72％；P = .009）。血统群组间的PV患病率有所差异（P < .001），AJ（39.9％）和亚洲人（26.5％）群组的患病率最高，而其他血统群组的患病率（>10％）类似。遗传血统的使用显示了类似结果，并进一步描绘了EAS/SAS群组中的高PV患病率。较年轻的年龄，高级别浆液性组织学和自述的AJ或亚洲血统与EOC相关基因的PV相关联。新识别PV的CGS咨询率在所有血统群组中较高（80％）。 无论血统如何，尤其是在EOC相关基因中，PV患病率很高，各群组间接受咨询的比率相似，强调在所有EOC患者中进行全面遗传测试的重要性。

To evaluate rates of germline pathogenic/likely pathogenic variants (PVs) and genetic counseling by ancestry in patients with epithelial ovarian cancer (EOC).Patients with pathologically confirmed EOC who underwent clinical tumor-normal sequencing from January 1, 2015, to December 31, 2020, inclusive of germline analysis of ≥76 genes were included. Patients with newly identified PVs were referred for Clinical Genetics Service (CGS) counseling. Ancestry groups were defined using self-reported race/ethnicity and Ashkenazi Jewish (AJ) heritage. Genetic ancestry was inferred computationally using validated algorithms. Logistic regression models were built.Of 1,266 patients, self-reported ancestry (AJ, 17%; Asian, 10%; Black/African American, 5.4%; Hispanic, 6.2%; non-Hispanic White, 57%; other, 0.16%; unknown, 4.0%) correlated with genetic ancestry (AJ ancestry, 18%; admixed, 10%; African, 4%; East Asian [EAS], 6%; European, 56%; Native American, 0.2%; South Asian [SAS], 4%; unknown, 2%). Germline PVs were observed in 313 (25%) patients, including 195 (15%) with PVs in EOC-associated genes. Those with PVs were younger at diagnosis (59 v 62 years; P < .001) and more likely to have high-grade serous ovarian cancer (83% v 72%; P = .009). PV prevalence varied between ancestry groups (P < .001), with highest rates in the AJ (39.9%) and Asian (26.5%) groups and similar rates (>10%) across other ancestry groups. Use of genetic ancestry demonstrated similar findings and further characterized high rates of PV in EAS/SAS groups. Younger age, high-grade serous histology, and self-reported AJ or Asian ancestry were associated with PV in an EOC-associated gene. Rates of CGS counseling for newly identified PVs were high (80%) across ancestry groups.Rates of PV, particularly in EOC-associated genes, were high regardless of ancestry, with similar rates of counseling between groups, emphasizing the importance of universal genetic testing in all patients with EOC.