Ovarian cancer is relatively uncommon, with a lifetime risk for women somewhere between 1 in 71 to 1 in 95. There is no effective form of screening for ovarian cancer. Methods that have been tested either have far too many false positives or have not been shown to affect outcomes. Sadly, most cases of ovarian cancer are diagnosed too late for surgery to be curative. Removing the ovaries before cancer develops to prevent ovarian cancer is problematic because the ovary makes estrogen, important for many functions throughout the body. Women who are at high risk for ovarian cancer will sometimes do this, but it’s generally not recommended for those without a family history of the disease.

    Over the last decade, researchers have concluded that one of the deadliest types of ovarian cancer does not actually begin in the ovary. Its origin is the fallopian tube, which carries the egg from the ovary to the uterus. Gynecologists have wondered if they could decrease the incidence of ovarian cancer by removing the fallopian tubes, while leaving the ovaries in place to make their important hormones. This procedure is called salpingectomy.

    A recent research letter in JAMA Network Open described an analysis of medical records in British Columbia, Canada. Ovarian cancer was much less frequent in women who had their fallopian tubes removed. As a result of this and similar studies, physicians are starting to discuss removing fallopian tubes opportunistically. “Opportunistic salpingectomy” means removal of the fallopian tubes when surgery is done for an unrelated issue, for example, gallbladder surgery. This concept is relatively new. Surgeons outside the gynecologic community might not be aware of it.

    The website Outsmart Ovarian Cancer is dedicated to this topic. The website has much valuable information, but they seem to be advocating surgery for everyone. Unless a woman is at very high risk of ovarian cancer because of a strong family history or genetics, I would not recommend getting surgery specifically for salpingectomy because the overall incidence of ovarian cancer is low. Any surgical procedure carries risk.

    On the other hand, if an abdominal surgery is planned anyway, having the fallopian tubes removed might make sense. It’s worth discussing with the surgeon.