What Is the Relationship Between Fallopian Tubes and Ovarian Cancer?
As doctors learn more about the origins of ovarian cancer, they develop new ways to try to prevent it. Research shows that many types of ovarian cancers begin in the fallopian tubes. This includes some of the most common types of ovarian cancer and high-grade serous cancer.1-3
To reduce the risk of ovarian cancer, doctors recommend that some people have their fallopian tubes surgically removed. This procedure is called a salpingectomy.1-3
What is an opportunistic salpingectomy?
An opportunistic salpingectomy is when doctors remove the fallopian tubes to prevent cancer from developing. This procedure can be done while a person is having a different pelvic surgery, such as a hysterectomy.1-3
A salpingectomy removes only the fallopian tubes. The ovaries are left intact, so the procedure does not disrupt ovarian function. That means a salpingectomy will not trigger menopause. It also means pregnancy through in vitro fertilization-embryo transfer is possible.1,3
An opportunistic salpingectomy is considered a safe and effective procedure. It does not increase complications of the original surgery and can lower the risk of ovarian cancer. But it does not completely erase the risk of ovarian cancer.1,3
The link between fallopian tubes and ovarian cancer
In the past few decades, studies have shown that some types of ovarian cancer develop in the fallopian tubes. It started with scientists discovering BRCA gene changes (mutations). People who carry this gene mutation have a higher risk of developing ovarian cancer.1,4
The most common type of ovarian cancer is high-grade serous ovarian carcinoma (HGSOC). About 3 out of 4 cases of epithelial ovarian cancer are HGSOCs.5
HGSOC is likely caused by a type of lesion found in the fallopian tubes. These precancerous lesions are called serous tubal intraepithelial carcinomas (STICs).1,6
Researchers began studying the fallopian tubes of people with BRCA mutations and those with a family history of ovarian or breast cancer. The monitoring led to more reports of STICs. Scientists were able to link these precancerous lesions in the fallopian tubes of people with a BRCA mutation to HGSOCs.1,4,6
Scientists also found a link between the TP53 gene mutation and STICs.4
Tubal ligation versus salpingectomy to reduce cancer risk
Tubal ligation is a surgery to close off the fallopian tubes. It is commonly used for permanent birth control or sterilization. Some people refer to the procedure as getting their "tubes tied."6,7
Tubal ligation can reduce the risk of ovarian cancer. Data shows that tubal ligation reduces the risk for one type of ovarian cancer, epithelial ovarian carcinoma, and its subtypes. But tubal ligation does not work as well to protect against HGSOC.6,7
Ongoing research shows that opportunistic salpingectomy can provide better protection against ovarian cancer than tubal ligation:3,8,9
- Tubal ligation can lower the risk of ovarian cancer by 13 to 41 percent.
- Salpingectomy can lower the risk of ovarian cancer by 42 to 78 percent.
One study found that opportunistic salpingectomy worked better at preventing ovarian cancers than originally expected. Salpingectomy likely provides better protection against HGSOC because the fallopian tubes are fully removed.3,8
Opportunistic salpingectomy for the prevention of ovarian cancer
While many people respond to treatment, ovarian cancer can be fatal. HGSOC is considered the deadliest form of ovarian cancer, likely because it is diagnosed at a late stage. People with HGSOC also often have the cancer come back (recur).1,5,9
Opportunistic salpingectomy can help prevent this fatal type of ovarian cancer or its recurrence by removing the fallopian tubes, where HGSOC begins.3,8
Researchers, doctors, and medical organizations in several countries recommend opportunistic salpingectomy for people at both average and high risk of ovarian cancer. This recommendation is meant to lower the risk of ovarian cancer for people who are done having children.1,3,8
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