100+ Free ABOG Gynecologic Oncology Practice Questions

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Question 1

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Based on the LACC trial (Ramirez et al, NEJM 2018), what is the current recommended surgical approach for early-stage cervical cancer (stage IA1 with LVSI, IA2, IB1)?

Laparoscopic radical hysterectomy

Robotic radical hysterectomy

Open abdominal radical hysterectomy (demonstrated superior disease-free and overall survival vs minimally invasive)

Radical trachelectomy only

to track

2026 Statistics

Key Facts: ABOG Gynecologic Oncology Exam

36 months

Fellowship Duration

ACGME-accredited Gynecologic Oncology

~30%

Ovarian Cancer Blueprint Weight

Largest single disease domain

2023 FIGO

Endometrial Staging

Incorporates molecular classification

LACC

Landmark Cervical Trial

Open > MIS radical hysterectomy

AUC 5-6

Carboplatin Dosing

Standard first-line ovarian

8 years

Certification Time Limit

From fellowship completion

The ABOG Gyn Onc QE is a computer-based single-best-answer MCQ examination administered annually at Pearson VUE testing centers. Content is organized by the ABOG subspecialty blueprint, emphasizing ovarian cancer (~30%), endometrial cancer (~25%, now with molecular classification under 2023 FIGO), cervical cancer (~20%, post-LACC era), vulvar/vaginal/GTD (~15%), and palliative/research/systems (~10%). Eligibility requires passing the ABOG Specialty QE, completion of a 36-month ACGME-accredited Gyn Onc fellowship, and a defended thesis. Passing the QE is required to advance to the oral Certifying Exam.

Sample ABOG Gynecologic Oncology Practice Questions

Try these sample questions to test your ABOG Gynecologic Oncology exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Based on the LACC trial (Ramirez et al, NEJM 2018), what is the current recommended surgical approach for early-stage cervical cancer (stage IA1 with LVSI, IA2, IB1)?

A.Laparoscopic radical hysterectomy

B.Robotic radical hysterectomy

C.Open abdominal radical hysterectomy (demonstrated superior disease-free and overall survival vs minimally invasive)

D.Radical trachelectomy only

Explanation: The LACC trial (2018) randomized 631 women with early-stage cervical cancer to open vs minimally invasive radical hysterectomy. MIS (laparoscopic or robotic) was associated with significantly worse 4.5-year DFS (86% vs 96.5%) and OS (93.8% vs 99%). The trial was stopped early. Current NCCN guidelines recommend OPEN abdominal radical hysterectomy for early-stage cervical cancer. Radical trachelectomy (fertility preservation) is an option for select patients with <2 cm tumors.

2A 42-year-old with biopsy-proven stage IB3 (tumor 4-5 cm) cervical squamous cell carcinoma is being managed with concurrent chemoradiation. What is the standard radiosensitizing chemotherapy?

A.Carboplatin AUC 5 every 3 weeks

B.Weekly cisplatin 40 mg/m² (max 70 mg) concurrently with external-beam radiation

C.Paclitaxel 175 mg/m² every 3 weeks

D.Doxorubicin-based regimen

Explanation: For locally advanced cervical cancer (stage IB3, II-IVA), concurrent chemoradiation with weekly cisplatin 40 mg/m² (max 70 mg per dose) during external-beam radiation has been standard since 1999 (5 pivotal trials showed improved survival). Modern protocols: EBRT (45-50 Gy) + brachytherapy (high-dose-rate) + weekly cisplatin × 5-6 cycles. KEYNOTE-A18 (pembrolizumab added to chemoradiation) improved PFS in locally advanced disease and is being incorporated in recent NCCN guidelines.

3A 50-year-old with FIGO stage III cervical cancer (pelvic lymph nodes positive on PET-CT) is being counseled about FIGO 2018 staging. What change did the 2018 FIGO update introduce?

A.Imaging and pathology findings are now incorporated into staging (previously clinical only)

B.Stage I was eliminated

C.Paraaortic nodes are no longer counted

D.Tumor size is no longer relevant

Explanation: The 2018 FIGO update for cervical cancer incorporated imaging (MRI, CT, PET-CT) and pathology findings into staging — moving away from purely clinical staging. Key changes: Stage IB was subdivided (IB1 <2 cm, IB2 2-4 cm, IB3 ≥4 cm); Stage IIIC was added for lymph node involvement (IIIC1 pelvic nodes, IIIC2 paraaortic nodes) regardless of tumor size or parametrial invasion. This better reflects prognosis and modern practice where imaging is universal.

4Which of the following is the preferred sentinel lymph node mapping technique in early-stage endometrial cancer?

A.Cervical injection of indocyanine green (ICG) with near-infrared fluorescence

B.Subserosal injection of blue dye

C.Hysteroscopic injection of radioisotope

D.Paraaortic lymph node biopsy

Explanation: Cervical injection of ICG (1.25 mg/mL) in 4 superficial (3/9 o'clock) and deep (3/9 o'clock) sites, followed by near-infrared fluorescence visualization, is the preferred SLN mapping technique for endometrial cancer. Bilateral SLN mapping detection rates exceed 80% in experienced hands. The FIRES trial validated this approach with high sensitivity. Ultrastaging (additional sectioning and IHC) is performed on SLNs for micrometastases. If no SLN on one side, side-specific pelvic lymphadenectomy is performed.

5The 2023 FIGO endometrial cancer staging incorporates molecular classification (POLEmut, MMRd/MSI-H, p53abn, NSMP). Which molecular subtype has the BEST prognosis?

A.p53 abnormal (p53abn)

B.POLE ultramutated (POLEmut) — excellent prognosis; typically Stage I even with grade 3 or LVSI

C.MMRd (mismatch repair deficient)

D.NSMP (no specific molecular profile)

Explanation: POLE ultramutated (POLEmut) endometrial cancers have excellent prognosis regardless of grade or LVSI — FIGO 2023 classifies these as stage I unless advanced anatomically. POLEmut is identified by sequencing of POLE exonuclease domain (hotspot mutations). Patients with Stage I POLEmut tumors may not need adjuvant therapy (PORTEC-3 subgroup analysis). p53abn (serous-like) has worst prognosis. MMRd has intermediate prognosis and is a predictor of immunotherapy response. NSMP has heterogeneous outcomes.

6Universal Lynch syndrome screening of all endometrial cancers is recommended using which initial test?

A.Germline BRCA1/2 testing

B.Immunohistochemistry (IHC) for MLH1, MSH2, MSH6, and PMS2 proteins (± MLH1 methylation if MLH1 loss)

C.Circulating tumor DNA

D.CA-125 level

Explanation: SGO and ACOG recommend universal screening of all endometrial cancers for Lynch syndrome, regardless of age or family history. Initial testing is IHC for the 4 MMR proteins (MLH1, MSH2, MSH6, PMS2). If MLH1 is lost, reflex MLH1 promoter methylation testing distinguishes sporadic (methylated) from likely Lynch (unmethylated, requiring germline testing). Loss of MSH2, MSH6, or PMS2 triggers genetic counseling and germline testing. Lynch syndrome affects ~2-6% of endometrial cancers; identification has implications for patient (colon screening) and family.

7A 58-year-old with stage IIIC ovarian high-grade serous carcinoma undergoes successful primary debulking (no residual disease). What is the standard adjuvant chemotherapy?

A.Carboplatin AUC 5-6 + paclitaxel 175 mg/m² IV every 3 weeks × 6 cycles

B.Single-agent cisplatin

C.Doxorubicin + cyclophosphamide (AC)

D.Single-agent bevacizumab

Explanation: First-line standard for ovarian HGSC: carboplatin AUC 5-6 IV + paclitaxel 175 mg/m² IV every 3 weeks × 6 cycles. Dose-dense weekly paclitaxel (80 mg/m²) + carboplatin was explored (JGOG 3016 showed benefit in Japanese population; GOG-262 and ICON8 did not confirm in Western populations — not standard). Intraperitoneal cisplatin (GOG-172) showed benefit but toxicity limited adoption. Bevacizumab may be added for select high-risk patients (GOG-218, ICON7). PARP inhibitor maintenance (olaparib, niraparib) after response for BRCA+/HRD+.

8A 62-year-old with BRCA1 germline mutation and newly diagnosed stage IIIC HGSC has a complete response after first-line carboplatin/paclitaxel. What is the most appropriate maintenance therapy?

A.Olaparib (PARP inhibitor) for 2 years (SOLO1 trial)

B.Tamoxifen

C.Observation with CA-125 monitoring

D.Continue carboplatin/paclitaxel indefinitely

Explanation: The SOLO1 trial (NEJM 2018) demonstrated olaparib 300 mg BID for 2 years as maintenance after first-line chemotherapy in BRCA1/2+ ovarian cancer patients who had complete/partial response produced unprecedented improvement in PFS (HR 0.30) and likely OS benefit. Olaparib is standard-of-care maintenance for BRCA+ after first-line response. Niraparib (PRIMA) is an option for HRD+ regardless of BRCA status. Rucaparib (ATHENA-MONO) is another option. Duration: 2 years for olaparib in SOLO1; niraparib typically 3 years.

9A 65-year-old with apparent stage IIIC ovarian cancer has extensive disease on imaging that is deemed unresectable for optimal debulking. What is the appropriate management strategy?

A.Primary debulking surgery regardless of resectability

B.Neoadjuvant chemotherapy (3 cycles) → interval debulking surgery → adjuvant chemotherapy (3 cycles) — supported by EORTC 55971 and CHORUS trials

C.Chemotherapy alone without surgery

D.Radiation therapy

Explanation: EORTC 55971 and CHORUS trials demonstrated that NACT (3 cycles carbo/taxol) + interval debulking + 3 more cycles is non-inferior to PDS for stage IIIC/IV ovarian cancer, with lower surgical morbidity. NACT is preferred when R0 debulking is unlikely at PDS (high tumor burden, poor performance status, medical comorbidities). SCORPION trial also supported NACT in high tumor burden. However, PDS remains preferred when R0 resection is achievable (MEMORY trial). Surgical assessment, laparoscopic staging (Fagotti score), and multidisciplinary evaluation guide decision.

10A 35-year-old BRCA1 mutation carrier who has completed childbearing should be offered which risk-reducing strategy?

A.Annual CA-125 and TVUS only

B.Risk-reducing bilateral salpingo-oophorectomy (RRSO) between age 35-40 (BRCA1) or 40-45 (BRCA2)

C.Prophylactic hysterectomy alone

D.Oral contraceptives as sole strategy

Explanation: BRCA1 carriers have 40-44% lifetime ovarian cancer risk; RRSO at age 35-40 after completion of childbearing reduces ovarian cancer risk by ~80% and breast cancer risk by ~50% (if premenopausal). BRCA2 carriers (~17% lifetime risk) — RRSO at 40-45. Surveillance with CA-125 and TVUS has poor sensitivity/specificity and is inadequate for prevention. Hormone therapy to age 50-51 after RRSO is acceptable for symptoms without increasing breast cancer risk in BRCA carriers per some data. Hysterectomy may be considered at time of RRSO (eliminates tamoxifen-related endometrial cancer risk).

About the ABOG Gynecologic Oncology Exam

The ABOG Gynecologic Oncology Subspecialty Qualifying Examination is a written computer-based board examination for graduates of an ACGME-accredited 3-year Gynecologic Oncology fellowship. It is the first of the two-step ABOG subspecialty certification process and assesses knowledge required for independent subspecialty practice — cervical, endometrial, ovarian, vulvar, and vaginal cancers plus gestational trophoblastic disease; surgical cytoreduction; systemic therapy (chemotherapy, targeted agents including PARP inhibitors, immunotherapy); radiation principles; palliative and end-of-life care; and clinical trial/research methodology. Passing the QE is prerequisite to sitting for the oral Certifying Examination (CE).

Questions

250 scored questions

Time Limit

Computer-based at Pearson VUE testing centers (exact duration set per cycle)

Passing Score

Scaled score with criterion-referenced cut-point set by ABOG

Exam Fee

Subspecialty QE fee per cycle (ABOG portal); $2,145 re-entry fee (ABOG 2026) (American Board of Obstetrics and Gynecology (ABOG))

ABOG Gynecologic Oncology Exam Content Outline

~20%

Cervical Cancer

HPV biology, CIN/AIS management, 2018 FIGO staging (now incorporates imaging), Querleu-Morrow radical hysterectomy types (A/B/C1/C2/D), LACC trial (abdominal approach superior to MIS for early-stage cervical), sentinel lymph node mapping (bilateral mapping), weekly cisplatin 40 mg/m² chemoradiation for locally advanced disease (stage IB3-IVA), radical trachelectomy for fertility preservation, pembrolizumab + chemotherapy + bevacizumab for PD-L1+ metastatic/recurrent, tisotumab vedotin (ADC) for recurrent.

~25%

Endometrial Cancer

2023 FIGO staging (incorporates molecular classification: POLEmut, MMRd/MSI-H, p53abn, NSMP). ProMisE/TCGA molecular classification. Lynch syndrome screening (universal IHC for MLH1/MSH2/MSH6/PMS2 on all endometrial cancers). Sentinel lymph node mapping with indocyanine green (cervical injection, dual injection). Adjuvant therapy by risk (PORTEC-3: chemoradiation for high-risk; GOG-249: carboplatin/paclitaxel for serous; KEYNOTE-775: pembrolizumab/lenvatinib for recurrent; dostarlimab + pembrolizumab for dMMR).

~30%

Ovarian Cancer & Peritoneal Disease

Epithelial (HGSC most common, BRCA-associated; LGSC/serous borderline; endometrioid; clear cell — MSI/ARID1A; mucinous — KRAS/HER2). Germ cell (dysgerminoma, endodermal sinus/yolk sac, immature teratoma), sex-cord stromal (granulosa cell — inhibin). 2014 FIGO staging. PDS vs NACT (SCORPION, CHORUS, EORTC 55971). Carboplatin AUC 5-6 + paclitaxel 175 mg/m² IV q3wk × 6 cycles. PARP inhibitors (olaparib, niraparib, rucaparib) maintenance for BRCA+ and HRD+. Bevacizumab. HIPEC (OVHIPEC trial). Mirvetuximab soravtansine (FRα+).

~15%

Vulvar, Vaginal, & Gestational Trophoblastic Disease

Vulvar SCC: wide local excision with 1-2 cm margins; sentinel lymph node (Tc-99m + blue dye) for lesions <4 cm unifocal with DOI >1 mm and clinically negative groins (GOG-173, GROINSS-V); inguinofemoral lymphadenectomy for larger/multifocal tumors or positive sentinel nodes. Vulvar melanoma (wide excision, no universal lymphadenectomy). Vaginal cancer staging/treatment. GTD: post-molar surveillance; single-agent MTX or dactinomycin for low-risk GTN; EMA-CO regimen for high-risk (WHO FIGO score ≥7). Placental site trophoblastic tumor (less chemo-sensitive).

~10%

Palliative Care, Research, Ethics

Palliative care integration in advanced cancer; malignant bowel obstruction management (octreotide, metoclopramide, steroids, consideration of venting gastrostomy, stents); pain management (opioid dosing, equianalgesic conversion); goals-of-care discussions; hospice eligibility. Clinical trial design (phase 1/2/3), GCIG CA-125 criteria, response criteria (RECIST), biostatistics (hazard ratio, overall survival vs PFS). Ethics and shared decision-making. Health disparities in gynecologic cancer.

How to Pass the ABOG Gynecologic Oncology Exam

What You Need to Know

Passing score: Scaled score with criterion-referenced cut-point set by ABOG
Exam length: 250 questions
Time limit: Computer-based at Pearson VUE testing centers (exact duration set per cycle)
Exam fee: Subspecialty QE fee per cycle (ABOG portal); $2,145 re-entry fee (ABOG 2026)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABOG Gynecologic Oncology Study Tips from Top Performers

1Master the 2023 FIGO endometrial staging: POLEmut Stage I is always favorable (excellent prognosis, often needs NO adjuvant therapy); p53abn upstages from pathologic to more advanced FIGO stages; MMRd/MSI-H may benefit from checkpoint inhibitors (pembrolizumab, dostarlimab) in advanced disease — know the molecular classification via IHC (p53, MMR proteins) + POLE sequencing + ProMisE algorithm

2Know the LACC trial results: minimally invasive radical hysterectomy for early-stage cervical cancer (stage IA1 LVSI+, IA2, IB1) had inferior DFS and OS compared with open abdominal surgery — the current standard is OPEN radical hysterectomy for early-stage cervical cancer; sentinel lymph node mapping with bilateral mapping replaces universal pelvic lymphadenectomy

3Memorize first-line ovarian cancer chemotherapy: carboplatin AUC 5-6 IV + paclitaxel 175 mg/m² IV q3 weeks × 6 cycles after primary debulking surgery or as NACT (3 cycles, interval debulking, 3 more cycles); add bevacizumab 15 mg/kg q3 weeks in select patients (high-risk stage III, IV); PARP inhibitor maintenance (olaparib, niraparib) for BRCA+ and HRD+ after first-line response

4For vulvar SCC: unifocal tumors <4 cm with DOI >1 mm and clinically negative groins qualify for sentinel lymph node biopsy with Tc-99m + blue dye (GOG-173, GROINSS-V I/II); multifocal, >4 cm tumors, or clinically positive groins require complete inguinofemoral lymphadenectomy; surgical margins of 1-2 cm; radical wide local excision rather than radical vulvectomy unless involvement dictates

5Know EMA-CO regimen for high-risk GTN (WHO score ≥7): Etoposide + Methotrexate + Actinomycin-D (EMA) alternating with Cyclophosphamide + Oncovin/Vincristine (CO); response rate >80%; add or switch to EP-EMA or platinum-containing regimens for resistance; low-risk GTN (WHO score ≤6) is treated with single-agent methotrexate (multi-day or weekly) or dactinomycin with response rates >90%

Frequently Asked Questions

What is the ABOG Gynecologic Oncology Subspecialty Qualifying Exam?

The ABOG Gyn Onc Qualifying Exam is a written computer-based multiple-choice board exam taken by graduates of an ACGME-accredited 3-year Gynecologic Oncology fellowship. It is the first of the two-step ABOG subspecialty certification process and assesses foundational knowledge required for independent practice of gynecologic oncology, including cervical/endometrial/ovarian/vulvar/vaginal cancers, GTD, surgical cytoreduction, chemotherapy and targeted therapy, radiation, palliative care, and research methodology. Candidates must pass the QE before sitting for the oral Certifying Examination (CE).

What topics are tested on the Gynecologic Oncology QE?

The ABOG Gyn Onc subspecialty blueprint emphasizes: cervical cancer (~20%) including HPV biology, Querleu-Morrow radical hysterectomy, LACC trial, and chemoradiation; endometrial cancer (~25%) with 2023 FIGO staging incorporating molecular classification (POLE, MMRd/MSI-H, p53abn, NSMP) and Lynch syndrome; ovarian cancer (~30%) with histologic subtypes, PDS vs NACT, PARP inhibitors, HIPEC; vulvar/vaginal cancer and GTD (~15%) including sentinel node mapping and EMA-CO; and palliative care, research, and ethics (~10%).

What are the eligibility requirements for the Gyn Onc QE?

Candidates must (1) hold current ABOG Specialty Active Candidate status by having passed the ABOG Specialty Qualifying Exam; (2) have completed (or be within 4 months of completing — at least 32 of 36 months at application) an ACGME-accredited 3-year Gynecologic Oncology fellowship; (3) successfully defend a thesis before June 15 of the exam year; and (4) hold an unrestricted medical license if any license is held. Fellowship must be complete by September 30 of the exam year or results are voided.

What is the format and length of the Gyn Onc Qualifying Exam?

The Gyn Onc QE is a written computer-based examination delivered at Pearson VUE testing centers. It consists of single-best-answer multiple-choice questions with many items constructed to test clinical judgment in complex, multi-disease scenarios. Exact length is set per cycle by ABOG. The exam is delivered in English only. Score reports include percent correct by major topic area.

What is the passing score for the Gyn Onc QE?

ABOG reports a scaled score and pass/fail result with criterion-referenced cut-point set through standard-setting (not curved). Score reports include domain-level percentages. Subspecialty QE first-time pass rates are generally 80-90% depending on cycle and cohort. Candidates have 8 years from fellowship completion to achieve subspecialty certification before additional supervised practice is required to regain eligibility.

What is the highest-yield content on the Gyn Onc QE?

High-yield topics: 2023 FIGO endometrial staging (molecular classification: POLEmut favorable, p53abn unfavorable, MMRd/MSI-H variable); LACC trial (open radical hysterectomy superior to minimally invasive for early-stage cervical cancer); sentinel lymph node mapping technique (ICG for endometrial, Tc-99m + blue dye for vulvar); carboplatin AUC 5-6 + paclitaxel 175 mg/m² for ovarian cancer; PARP inhibitor indications (olaparib, niraparib, rucaparib — BRCA1/2 and HRD status); NACT vs PDS for bulky stage III/IV ovarian; Lynch syndrome universal testing with IHC on all endometrial cancers; EMA-CO regimen for high-risk GTN.

How is the Gyn Onc QE different from the ABOG Specialty QE?

The Specialty QE (general OB/GYN) is taken after residency and covers broad obstetrics (33%), gynecology (33%), and office practice (33%). The Gyn Onc subspecialty QE is focused at the fellow/attending level on gynecologic cancers, their surgical management (radical hysterectomy, cytoreduction), systemic therapy (chemotherapy, targeted agents, immunotherapy), radiation principles, genetic syndromes (BRCA, Lynch), palliative care, and clinical research/trials. Candidates must first pass the Specialty QE to be eligible for any subspecialty QE.

How should I prepare for the ABOG Gyn Onc Qualifying Exam?

Use a structured 12-18 month study plan during fellowship. Review NCCN Gynecologic Cancer Guidelines comprehensively, SGO clinical practice guidelines, key landmark trials (LACC, PORTEC series, GOG series, KEYNOTE-775, SOLO1, SOLO2, NOVA, PRIMA, SCORPION, CHORUS), and ASCO position statements. Master 2018 FIGO cervical, 2023 FIGO endometrial (molecular classification), 2014 FIGO ovarian, and vulvar staging. Complete fellow-level Q-banks, review multidisciplinary tumor board cases from fellowship, and take timed practice exams. Study clinical trial design and biostatistics (integral to the blueprint).