Ovarian cancer risk reduction through opportunistic salpingectomy.

Abstract

There has been increasing evidence over the past decade that the majority of ovarian cancers arise in the fallopian tube and not primarily in the ovary [1,2,3]. In 2010 the British Columbia Ovarian Cancer Research Group (OVCARE) launched an educational campaign about the potential benefit of done concurrently with hysterectomy for benign gynecologic conditions, or instead of tubal ligation as surgical sterilization. It was estimated that this practice could reduce ovarian cancer risk by 20% to 40% over the next 20 years [4]. Salpingectomy is favorable to salpingo-oophorectomy because it avoids health risks associated with premature menopause after oophorectomy, including osteoporosis and coronary heart disease [5]. However, there has been skepticism about the safety and absolute benefit of this practice [6,7]. There are no long-term studies confirming that salpingectomy does not compromise ovarian function. Similarly, there are no long-term clinical studies confirming that the fallopian tube is the site of origin of most ovarian cancers. However, the available evidence so far suggests that opportunistic salpingectomy is safe, and likely to be effective and cost-effective as an ovarian cancer prevention strategy.