Fallopian Tube Removal May Help Prevent Ovarian Cancer

March 22, 2023

While relatively rare, ovarian cancer causes more deaths than any other cancer of the female reproductive system. According to the American Cancer Society, nearly 20,000 women will be diagnosed with ovarian cancer every year, and more than 13,000 women will die from it.

There is currently no effective screening option for ovarian cancer, and the only proven method to reduce mortality risk from ovarian and fallopian tube cancer is the surgical removal of the ovaries and fallopian tubes. In fact, women who are at high-risk for ovarian cancer through family history or genetics have routinely been advised to have their fallopian tubes and ovaries removed after they are done with childbearing.

Latest Data Focused on Fallopian Tubes

There is mounting evidence that a large proportion of ovarian cancer actually begins in the fallopian tubes –at least 70 percent of the most common and deadly form of ovarian cancer. There is data to suggest that surgically removing fallopian tubes after childbearing reduces the risk for cancer, says University Hospitals gynecologic oncologist Amy Armstrong, MD.

In light of this data, the Ovarian Cancer Research Alliance (OCRA) recently made the recommendation that all women who have finished having children consider having their fallopian tubes removed – leaving the ovaries in place – even if they are low or average risk. The procedure, known as a salpingectomy, is recommended specifically for women who are already planning a pelvic surgery for another reason, and not as a stand-alone surgery.

“We can justify doing an opportunistic salpingectomy in women already undergoing surgery for other reasons, such as tubal sterilization or hysterectomy, because doing this at the time of an already planned procedure adds neither cost nor risk,” Dr. Armstrong explains.

Benefits of Fallopian Tube Removal

Removing the fallopian tubes is a relatively simple procedure. And because it leaves the ovaries intact, an opportunistic salpingectomy has other benefits as well. Dr. Armstrong says that removing the ovaries prior to age 60 may increase one’s risk for cardiovascular events – a far more common problem – thus increasing a low-risk woman’s risk of mortality overall. The hormones produced by the ovaries can also help prevent thing such as osteoporosis and low sex drive in premenopausal women.

Dr. Armstrong notes that removing the fallopian tubes will not completely eliminate the risk for ovarian cancer, but can reduce the risk incrementally.

The Society of Gynecologic Oncology (SGO) has endorsed the OCRA’s latest recommendations, and both the SGO and the American College of Obstetricians and Gynecologists (ACOG), have made similar statements in the past. Both organizations have suggested that removing the fallopian tubes, when paired with another planned gynecologic surgery, can be an effective cancer prevention strategy.

Importance of Knowing Your Risk

The OCRA also stresses the importance of women learning about their individual risk, because certain predispositions can put a woman at a much higher risk for developing ovarian cancer. Having a family history of breast, ovarian, uterine or colorectal cancer increases your risk, as well as certain genetic mutations. The lifetime risk of ovarian and related cancers for women with the BRCA1/2 cancer gene mutation is about 30 – 50 percent, compared to about 1.3 percent for the general population.

Conversely, pregnancy, breastfeeding and the use of oral contraceptives have been known to decrease the risk of ovarian cancer.

Genetic testing should be considered if you have a personal or family history of certain cancers, or if you have a relative who is a known carrier of the BRCA1/2 mutation. Dr. Armstrong says talking to your healthcare provider or a genetic counselor can give you better insight into whether you are a good candidate for genetic testing.

Knowing your risk can put you in a better position to decide if preventive actions – such as opportunistic fallopian tube removal, or removing both fallopian tubes and ovaries – are right for you.