Women undergoing routine pelvic surgeries may want to consider having their fallopian tubes removed as a preventive measure against ovarian cancer. The Ovarian Cancer Research Alliance (OCRA) recently highlighted this recommendation, citing that the most aggressive type of ovarian cancer often begins in the fallopian tubes. If someone has completed childbearing, removing these tubes could significantly lower their risk.
While not mandatory, the guidance encourages more discussions between patients and healthcare providers regarding this preventive option. Given the absence of effective screening tools for ovarian cancer, removing fallopian tubes during benign pelvic surgeries is being emphasized as a proactive step.
A new recommendation
The recommendation from the OCRA applies to individuals having surgeries for non-cancerous conditions like hysterectomy, tubal ligation, or endometriosis. According to Dr. Susan Modesitt, removing the tubes post-childbearing has minimal negative effects.
Despite the name, most ovarian cancers—especially the aggressive types—originate in the fallopian tubes. Removing them, therefore, can greatly reduce the risk of developing the most deadly form of gynecological cancer.
In addition to encouraging fallopian tube removal, the OCRA urges healthcare professionals to stay informed about ovarian cancer symptoms and promote genetic testing to raise awareness.
Building on an existing idea
Though recently emphasized, the concept isn't new. For years, individuals with BRCA1 or BRCA2 gene mutations have been advised to undergo fallopian tube or ovary removal to reduce cancer risk.
When performed alongside another pelvic surgery, the fallopian tube removal procedure is known as an opportunistic salpingectomy. This proactive approach may benefit not only high-risk individuals but also those in the general population.
As early as 2013, medical groups recommended tube removal during surgeries like hysterectomies for average-risk women. The release of a 2021 study showing that ovarian cancer symptom awareness does not reduce mortality further solidified the case for this preventive strategy.
Why less-invasive screening doesn't work
Unlike other cancers, ovarian cancer lacks effective screening methods. While pelvic exams, ultrasounds, and CA-125 blood tests exist, they haven’t proven effective in reducing deaths.
Even early-stage detection through screening doesn't necessarily improve survival outcomes. In fact, studies show that identifying cancer earlier doesn’t always lead to longer survival.
Ovarian cancer is diverse and behaves differently than other tumors. It often starts with microscopic cells in the fallopian tubes that spread throughout the abdomen before forming detectable tumors. Symptoms such as bloating, pelvic pain, and fatigue often appear only in advanced stages.
Because of these unique characteristics, early detection doesn’t guarantee a better prognosis. For now, removing the source—the fallopian tubes—remains the most effective preventive action.
A simple procedure with significant impact
While salpingectomy is a surgical intervention, it’s not as disruptive as it may sound. The recommendation targets those already scheduled for pelvic surgeries. For high-risk individuals, the procedure may occur as early as age 35.
When added to an existing operation, fallopian tube removal takes only five to ten extra minutes. Since fallopian tubes don’t produce hormones, their removal doesn’t cause noticeable changes.
Research supports the effectiveness of this approach. A 2022 study found no cases of serious ovarian cancer in women who underwent salpingectomy.
Although any surgery carries risks like bleeding or infection, experts emphasize that this procedure poses minimal downsides and potentially life-saving benefits.
Encouraging informed conversations
The goal of the OCRA’s recommendation is not to impose a mandatory measure, but to open up meaningful discussions. If a woman is already undergoing surgery and doesn’t plan to have more children, it may be worth considering fallopian tube removal.
Each year, about 600,000 hysterectomies are performed in the U.S. If more women take advantage of this opportunity, the overall ovarian cancer rates could drop significantly.
Other preventive strategies include using birth control pills, which have been shown to reduce ovarian cancer risk. The OCRA also encourages genetic testing, increased awareness of symptoms, and participation in clinical research.
Dr. Karen Lu of MD Anderson Cancer Center emphasizes the importance of empowering women to have proactive conversations with their doctors. Preventing ovarian cancer could be within reach for many, but only if they are aware of and understand their options.
