Account

General Gynecology · Gynecologic Oncology

Outcomes From Opportunistic Salpingectomy for Ovarian Cancer Prevention

Hanley GE, Pearce CL, Talhouk A, Kwon JS, Finlayson SJ, McAlpine JN, Huntsman DG, Miller D

Published February 2022 JAMA network open
DOI 10.1001/jamanetworkopen.2021.47343 PMID 35138400 PMC PMC8829665

RRM Academy Synopsis

Opportunistic salpingectomy was associated with fewer ovarian cancers

A British Columbia cohort study found no serous ovarian cancers among 25 889 people who had opportunistic salpingectomy. The expected number was 5.27 serous cancers. The comparison group was 32 080 people who had hysterectomy alone or tubal ligation.

Key Findings

  • The cohort held 25 889 people who had opportunistic salpingectomy and 32 080 who had hysterectomy alone or tubal ligation, operated on between 2008 and 2017.
  • The opportunistic salpingectomy group had no serous ovarian cancers. The expected number was 5.27 (95% CI, 1.78-19.29).
  • The group had 5 or fewer epithelial ovarian cancers, with the exact number withheld for privacy. The expected number was 8.68 (95% CI, 3.36-26.58).
  • Breast cancers numbered 23 observed against 22.1 expected. Colorectal cancers numbered 8 observed against 9.35 expected.
  • Median follow-up was 3.2 years (IQR, 1.6-5.1) in the salpingectomy group and 7.3 years (IQR, 4.6-8.7) in the comparison group.

Interpretation

This retrospective cohort compared observed cancers with numbers expected from the comparison group's age-specific rates. Cancers were few and follow-up was short. The authors ran no statistical models, and the intervals around the expected numbers are wide. The design shows association. Unmeasured differences between groups remain possible. The salpingectomy group was older, had fewer births and had more endometriosis. The authors say these differences would bias the comparison toward more cancers in that group. Breast and colorectal counts matched expectations, which the authors say suggests selection bias is unlikely to explain the result.

RRM Context

Restorative reproductive medicine asks why a tube is diseased first. The cohort had hysterectomy or sterilization surgery. The paper says nothing about saving tubes.

Our editorial summary of this paper, not the article's abstract.

Abstract

Opportunistic salpingectomy (OS), which is the removal of fallopian tubes during hysterectomy or instead of tubal ligation without removal of ovaries, is recommended to prevent ovarian cancer, particularly serous ovarian cancer. However, the effectiveness of OS is still undetermined. To examine observed vs expected rates of ovarian cancer among individuals who have undergone OS. This is a population-based, retrospective cohort study of all individuals in British Columbia, Canada, who underwent OS or a control surgery (hysterectomy alone or tubal ligation) between 2008 and 2017, with follow-up until December 31, 2017. Those with any gynecological cancer diagnosed before or within 6 months of their procedure were excluded. Data analysis was performed from April to August 2021. Removal of both fallopian tubes at the time of hysterectomy or instead of tubal ligation while leaving ovaries intact. An ovarian cancer diagnosis listed in the British Columbia Cancer Registry. Age-specific rates of epithelial and serous ovarian cancer in the control group were combined with the specific follow-up time in the OS group to calculate expected numbers (and 95% CIs) of ovarian cancers in the OS group. These were compared with observed numbers. Age-adjusted expected and observed numbers of breast and colorectal cancers were also examined in the OS group. There were 25 889 individuals who underwent OS (mean [SD] age, 40.2 [7.1] years; median [IQR] follow-up, 3.2 [1.6-5.1] years) and 32 080 who underwent hysterectomy alone or tubal ligation (mean [SD] age, 38.2 [7.9] years; median [IQR] follow-up, 7.3 [4.6-8.7] years). There were no serous ovarian cancers in the OS group and 5 or fewer epithelial ovarian cancers. The age-adjusted expected number was 5.27 (95% CI, 1.78-19.29) serous cancers and 8.68 (95% CI, 3.36-26.58) epithelial ovarian cancers. Age-adjusted expected vs observed numbers of breast cancers (22.1 expected vs 23 observed) and colorectal cancers (9.35 expected vs 8 observed) were not significantly different. In this cohort study, the OS group had significantly fewer serous and epithelial ovarian cancers than were expected according to the rate at which they arose in the control group. These findings suggest that OS is associated with reduced ovarian cancer risk.

Topics

By this author

Related research

General Gynecology › Gynecologic Oncology › Ovarian Cancer · Reproductive Surgery › Tubal Surgery › Tubal Anastomosis
Gillian E Hanley, Celeste Leigh Pearce, Aline Talhouk, Janice S Kwon, Sarah J Finlayson, Jessica N McAlpine, David G Huntsman, Dianne Miller
G Hanley, C Pearce, A Talhouk, J Kwon, S Finlayson, Jess McAlpine, J McAlpine, Dave Huntsman, D Huntsman, D Miller
PMID 35138400 35138400 DOI 10.1001/jamanetworkopen.2021.47343 10.1001/jamanetworkopen.2021.47343 Hanley et al. 2022, Hanley 2022

Learn

Resources

Tools

Help

Candid Platinum Transparency 2026

RRM Academy is a 501(c)(3) nonprofit providing free and low-cost education in restorative reproductive medicine for patients and healthcare professionals.

This site is an educational resource and does not provide medical advice. Inclusion of a study does not imply endorsement of its findings. Always consult a qualified healthcare provider for diagnosis and treatment.

© 2026 RRM Academy · All Rights Reserved

Restorative Reproductive Medicine Foundation · 3401 Hartzdale Dr, Ste 103B PMB 3518, Camp Hill, PA 17011 · EIN: 93-4594315
Sitemap AI Instructions Developers Terms of Use Medical Disclaimer Privacy Policy