It is recommended that female PJS patients have annual gynecological examinations from the age of 25 years. In addition to cervical screening as performed in population-based screening programs that run in many countries, gynecological surveillance in female PJS patients should be focused on the detection of cervical adenocarcinomas, in particularly minimal deviation adenocarcinoma, and rare non-epithelial ovarian tumors. Surveillance for cervical adenocarcinomas should involve speculum examination and cervical screening ("Pap smear") including cytology even in an HPV-negative sample. Surveillance for non-epithelial ovarian cancers should involve bimanual pelvic examination with a transvaginal ultrasound in case of suspicion of a pelvic mass. CA125 testing is not indicated. Level of evidence: low Strength of recommendation: moderate