A new study published in JAMA Network Open by researchers at the University of British Columbia (UBC) reports that a prevention strategy called opportunistic salpingectomy (OS) can reduce the risk of developing serous ovarian cancer by nearly 80 percent. OS involves removing the fallopian tubes during routine gynecological surgeries such as hysterectomy or tubal ligation, while leaving the ovaries intact to preserve hormone production.
The approach was first introduced in British Columbia (B.C.) in 2010 after research revealed that most ovarian cancers originate in the fallopian tubes rather than the ovaries. Dr. Dianne Miller, associate professor emerita at UBC and gynecologic oncologist with Vancouver Coastal Health and BC Cancer, developed and named OS. She also co-founded OVCARE, B.C.'s multidisciplinary ovarian cancer research team.
"If there is one thing better than curing cancer it's never getting the cancer in the first place," said Dr. Miller.
Ovarian cancer remains the most lethal gynecological cancer, with about 3,100 Canadians diagnosed annually and approximately 2,000 deaths each year. The lack of a reliable screening test often means diagnosis occurs at advanced stages.
The study analyzed health data from over 85,000 people who underwent gynecological surgeries in B.C. between 2008 and 2020. It found that those who had OS were 78 percent less likely to develop serous ovarian cancer compared to those who did not undergo the procedure. In cases where ovarian cancer developed after OS, these cancers were generally less aggressive. The findings were further supported by pathology data from laboratories worldwide.
"This is the culmination of more than a decade of work that started here in B.C.," said Dr. David Huntsman, professor at UBC and distinguished scientist at BC Cancer. "The impact of OS that we report is even greater than we expected."
Since its introduction, OS has been widely adopted in B.C., now included in about 80 percent of hysterectomies and tubal ligations performed in the province. Professional medical organizations across 24 countries have recommended OS as an ovarian cancer prevention measure since guidance was issued by bodies like the Society of Obstetrics and Gynecology of Canada in 2015.
Researchers suggest that broader adoption of OS could prevent thousands of ovarian cancer cases globally each year. Recent policy changes have extended eligibility for OS to additional abdominal and pelvic surgeries performed by general and urologic surgeons in B.C., through initiatives supported by provincial authorities.
"Our hope is that more clinicians will adopt this proven approach, which has the potential to save countless lives," said Dr. Huntsman. "Not offering this surgical add-on may leave patients unnecessarily vulnerable to this cancer."
