- A new consensus statement from the Ovarian Cancer Research Alliance (OCRA) suggests some women should remove fallopian tubes in order to reduce the risk of ovarian cancer.
- Ovarian cancer screenings are often considered unsuccessful as they can lead to false positives that lead to unnecessary surgery and surgical complications.
- The average risk for ovarian cancer is low.
A new consensus statement from the Ovarian Cancer Research Alliance (OCRA) advises many women to remove their fallopian tubes in an effort to reduce their risk of developing ovarian cancer.
According to the statement, which published on January 30, ovarian cancer is a particularly challenging condition to diagnose and treat since, unlike many other types of cancer, the prognosis doesn’t necessarily improve with early diagnosis.
According to the OCRA consensus statement, people who are diagnosed early can have an aggressive form of ovarian cancer with a high rate of mortality, while others, who are diagnosed with late-stage ovarian cancer, may have a less-aggressive form and have more positive outcomes.
Ovarian cancer screenings are often considered unsuccessful as they can lead to false positives that lead to unnecessary surgery and surgical complications, according to the American College of Gynecology (ACOG).
The average risk for ovarian cancer is low, however, it is the deadliest type of gynecologic cancer and the fifth leading cause of cancer deaths among women.
“Individuals who do not desire future fertility and have completed childbearing can be counseled in regard to removal of the fallopian tubes at the time of gynecologic surgery for benign conditions,” Dr. Oliver Dorigo MD, PhD, the director and associate professor of gynecologic oncology at Stanford University, told Healthline.
Why fallopian tubes are linked to ovarian cancer
Opportunistic salpingectomy — the medical term for the removal of the fallopian tubes for the prevention of ovarian cancer — is increasingly recommended for at-risk women who are already undergoing some type of pelvic surgery, such as a hysterectomy or surgery for tubal ligations, cysts, and endometriosis.
According to Dr. Troy Gatcliffe, gynecologic oncologist at Baptist Health Miami Cancer Institute, many cases of ovarian cancer begin in the fallopian tubes.
Epithelial ovarian cancers (EOCs) make up about 90% of all ovarian cancers. The most common type of EOC, called high-grade serous ovarian cancer (HGSC), very often originates in the fallopian tubes before spreading to the ovary.
“As our ability to understand the cellular origin of tumors has evolved, we discovered the majority of serous epithelial ovarian cancers were of tubal origin. Therefore removing tubes can prevent up to 90% of ovarian cancers,” says Dr. G. Thomas Ruiz, the OB/GYN lead at MemorialCare Orange Coast Medical Center in Fountain Valley, CA.
Research shows that the procedure is safe, cost-effective, and low-risk.
“The removal of the fallopian tube is in general safe and preserve ovarian hormone production in premenopausal women,” Ruiz says.
Who should consider getting an opportunistic salpingectomy?
Certain women who are at-risk for ovarian cancer may want to consider having their fallopian tubes removed, per the new consensus statement.
Early signs of ovarian cancer are subtle, making them hard to detect, says Ruiz.
Genetic testing, which is done via a mouth swab or blood test, can help people identify if they carry a familial or hereditary gene, such as the BRCA genes, that increases their risk for ovarian cancer.
Anyone with a first-degree family member who has either been diagnosed with ovarian cancer or has a gene mutation putting that at risk for ovarian cancer should undergo genetic testing, advises Dorigo.
Those who carry a gene associated with ovarian cancer — such as the BRCA mutation — will be referred to a gynecologic oncologist who can recommend further screenings and risk-reducing surgeries, says Gatcliffe.
“In high-risk women with a known genetic predisposition, risk-reducing prophylactic removal of the tubes and ovaries is the standard of care once the patient has completed childbearing and is appropriately counseled and ready to undergo surgical menopause,” Gatcliffe said.
Opportunistic salpingectomy is not recommended to people who wish to preserve their future fertility.
“If that condition is met, and they are having pelvic surgery, counseling is appropriate to encourage salpingectomy to lower the risk ovarian cancer,” says Ruiz.
The bottom line:
A new statement from OCRA advises many women to remove their fallopian tubes — known as opportunistic salpingectomy — in an effort to reduce their risk of developing ovarian cancer. Doing so can prevent up to 90% of ovarian cancers.
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