Canadian researchers have developed a prevention strategy that can reduce the risk of the most common and deadly form of ovarian cancer by nearly 80%, according to a new study published in JAMA Network Open by researchers at the University of British Columbia (UBC).
The strategy, known as opportunistic salpingectomy (OS), involves removing a person’s fallopian tubes when they are already undergoing a common gynaecological procedure, such as a hysterectomy or tubal ligation, or “having one’s tubes tied.”
The team of researchers from UBC, the Canadian province of British Columbia (B.C.), and Vancouver Coastal Health designed the approach after it was discovered that most ovarian cancers originate in the fallopian tubes rather than the ovaries.
Opportunistic salpingectomy leaves a person’s ovaries intact, preserving important hormone production, meaning there are minimal side effects from the added procedure.
The internationally based collaboration known as the Ovarian Cancer Observatory provides the clearest evidence yet that the Canadian innovation saves lives.
Co-senior author Dr Gillian Hanley, an associate professor of obstetrics and gynaecology at UBC, explained that the study clearly demonstrates that removing the fallopian tubes as an add-on during routine surgery can help prevent the most lethal type of ovarian cancer.
According to her: “It shows how this relatively simple change in surgical practice can have a profound and life-saving impact.”
It remains one of the deadliest gynaecologic cancers. It is known as “the silent killer” due to its lack of symptoms and the absence of reliable screening tests.
No dependable screening method exists to detect ovarian cancer early, and symptoms such as bloating or abdominal pain may only become noticeable once the cancer has spread.
Once believed to begin in the ovaries, many common and aggressive forms of ovarian cancer are now thought to start in the fallopian tubes—two slender structures near the ovaries that provide the pathway for fertilisation but serve no essential function once a woman no longer desires future fertility.
The new study—the first to quantify how much OS reduces the risk of serous ovarian cancer—analysed population-based health data from more than 85,000 people who underwent gynaecological surgeries in B.C. between 2008 and 2020.
Researchers compared rates of serous ovarian cancer between those who had OS and those who had similar surgeries but did not undergo the procedure.
Overall, people who had OS were 78% less likely to develop serous ovarian cancer. In the rare cases where ovarian cancer occurred after OS, the cancers were found to be less biologically aggressive.
The findings were further validated by data collected from pathology laboratories around the world, which suggested a similar effect.
The researchers say expanding global adoption of OS could prevent thousands of ovarian cancer cases worldwide each year.