MSH6 and cancer: This aligns with recent recommendations for risk reducing salpingo-oophorectomy for MSH2 and MLH1 carriers and not for MSH6 and PMS2 carriers.3 In the Prospective Lynch Syndrome Database, ovarian cancer had a high 5 year and 10 year survival rate of 84%3 compared with 46% in the general Australian population.44 This could be due to the highly screened targeted population and younger age group included in the former, or the specific phenotype of Lynch syndrome cancers.