MSH6 and female reproductive organ cancer: Risk-reducing surgery (RRS) including total hysterectomy and bilateral salpingo-oophorectomy (BSO) prevents gynecological cancer in Lynch syndrome.8 The Manchester International Consensus Group strongly recommended that risk-reducing hysterectomy and BSO are offered no earlier than 35–40 years of age, following completion of childbearing in path_MLH1, path_MSH2, and path_MSH6 heterozygotes but the data supporting such recommendations are not strong, and various practices currently exist.