Opportunistic Salpingectomy Dramatically Lowers Ovarian Cancer Risk, finds study

A new study published in the Journal of the American Medical Association revealed that the chance of developing serous ovarian cancer was shown to be reduced by almost 80% when opportunistic bilateral salpingectomy (OBS) was added during the procedure when compared to hysterectomy alone.

A very deadly gynecologic cancer that is increasingly associated with the fallopian tubes is serous ovarian cancer. During benign gynecologic surgery, opportunistic bilateral salpingectomy has become a popular prophylactic measure. Assessing the incidence of cancer following this operation helps determine how effective and long-lasting it is.

The study was reported in accordance with STROBE guidelines. Cox proportional hazards models were used to compare opportunistic bilateral salpingectomy with hysterectomy alone or tubal ligation to evaluate the risk decrease for serous cancer. Due to the lack of histotype information, low-grade and high-grade serous carcinomas were examined together.

Potential selection bias was evaluated by looking at breast cancer outcomes. International pathologists provided anonymised data on ovarian carcinomas in patients lacking fallopian tubes to a RedCap database in order to achieve the second goal. Fisher exact tests were used to compare histotype distributions with historical data. SAS 9.4 and Stata 19 were utilized in the analyses, and P <.05.

A total of 85 823 individuals had pertinent operations in goal 1: 45 296 had comparator procedures (median follow-up 8.45 years) and 40 527 had opportunistic bilateral salpingectomy (OBS; median follow-up 4.72 years). The comparative group used oral contraceptives less often (50.0% vs. 60.7%) and was older at surgery (mean age 42.4 vs. 40.7 years). While the risk of breast cancer was comparable between groups (HR 0.99; 95% CI, 0.84–1.17), OBS was linked to a significantly decreased crude hazard of serous ovarian carcinoma (HR 0.22; 95% CI, 0.05–0.95).

Only 23.1% of the 26 ovarian carcinomas in Objective 2 were high-grade serous carcinomas, compared to 68.1% in a historical cohort with fallopian tubes (P <.001). Overall, these results demonstrate that wider use of OBS has the potential to dramatically lower the incidence and death of serous ovarian cancer and offer strong evidence for the efficacy of OBS as a preventative strategy.

Source:

Sowamber, R., Mei, A. J., Kaur, P., McLeod, J., McKay, E., Lukey, A., Bakkum-Gamez, J., Buza, N., Cohen, P. A., Devins, K., Farrell, R., Garcia, C., Gilks, B., Goode, E., Hodgson, A., Howitt, B., Hui, P., Huvila, J., Karnezis, A., … Hanley, G. E. (2026). Serous ovarian cancer following opportunistic bilateral salpingectomy. JAMA Network Open, 9(2), e2557267. https://doi.org/10.1001/jamanetworkopen.2025.57267