Salpingectomy does not increase risk of ovarian cancer: JAMA

A recent study by Vasily Giannakeas and team did not observe any connection between salpingectomy and the risk of ovarian cancer. The findings were published in the Journal of American Medical Association.

This study was undertaken because a body of clinical and pathological evidence suggests that a significant portion of high-grade serous ovarian cancers originates in the fallopian tube. Consequently, salpingectomy is now being considered for permanent contraception as an alternative to tubal ligation, or for ovarian cancer prevention when performed alongside surgical procedures for benign gynecologic conditions. The primary goal of this research was to investigate the potential link between salpingectomy and the risk of invasive epithelial ovarian, fallopian tube, and peritoneal cancer.

This retrospective cohort study, based on the population, encompassed all women between the ages of 18 and 80 who were eligible for healthcare services in Ontario, Canada. Participants were identified using health-related administrative databases from Ontario, covering the period from January 1, 1992, to December 31, 2019. The study involved a total of 131,516 women who were subjected to the primary (matched) analysis. These women were monitored until December 31, 2021. The primary criteria for the study involved comparing salpingectomy (with or without hysterectomy) to no pelvic procedure (the control condition) among women in the general population.

Specifically, women who underwent a unilateral or bilateral salpingectomy in Ontario between April 1, 1992, and December 31, 2019, were matched at a 1:3 ratio with women who had not undergone any pelvic procedure from the general population. Cox proportional hazards regression models were utilized to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the combined occurrence of ovarian, fallopian tube, and peritoneal cancer.

The Key findings of this study were:

Out of the 131,516 women included in the study, 32,879 had either a unilateral or bilateral salpingectomy, while 98,637 had not undergone any pelvic procedure.

Over an average follow-up period of 7.4 years (ranging from 0 to 29.2 years) in the salpingectomy group and 7.5 years (also ranging from 0 to 29.2 years) in the non-surgical control group, there were 31 newly diagnosed cases of cancer (0.09%) and 117 new cases of cancer (0.12%), respectively.

When comparing those who had salpingectomy to those who had hysterectomy alone, the hazard ratio (HR) for cancer incidence was 0.87. 

Reference:

Giannakeas, V., Murji, A., Lipscombe, L. L., Narod, S. A., & Kotsopoulos, J. (2023). Salpingectomy and the Risk of Ovarian Cancer in Ontario. In JAMA Network Open (Vol. 6, Issue 8, p. e2327198). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.27198