Ovarian Cancer Prevention
BC became the first jurisdiction in the world to launch an educational and prevention strategy with the goal of reducing the incidence of ovarian cancer in the province of BC by 40%.
Opportunistic Salpingectomy is as an Effective Prevention Strategy for Ovarian Cancer
British Columbia’s OVCARE research team was among the first to discover that a majority of high-grade serous ovarian cancers (HGSC- the most common type) originate from fallopian tubes. This was the silver lining that led to the practice of opportunistic salpingectomies (OS) for ovarian cancer prevention.
Opportunistic salpingectomy refers to the removal of both fallopian tubes at the time of another planned pelvic surgery, historically during hysterectomy or tubal sterilization. The term was coined by Dr. Dianne Miller, who pioneered this procedure for ovarian cancer prevention in 2010. By providing the option to remove the fallopian tubes in women with average risk who were already undergoing pelvic surgery for benign disease, OS has been found to reduce one’s risk for ovarian cancer (Hanley, et al., 2022 ).
Clinical Impact
In 2010, OVCARE suggested that BC gynecologists consider OS for primary prevention of ovarian cancer. BC became the first jurisdiction in the world to launch an educational and prevention strategy promoting OS. Since then, OS has been recommended by the Society of Gynecologic Oncology of Canada, the Society of Obstetricians and Gynaecologists of Canada, and many others. By 2018, a total of 9 countries had released statements further endorsing OS as a safe and effective procedure for reducing ovarian cancer risk. The 4 remaining FIGO countries remain ambivalent, and none have released any statements against OS for ovarian cancer prevention (Ntoumanoglou-Schuiki, et al., 2018).
Ongoing Research
The GCI continues to foster ongoing research efforts to further optimize OS and other methods of ovarian cancer prevention. They have worked to ensure that women are aware of their risk for ovarian cancer and informed about risk-reducing options. While OS has already proven to be effective in preventing high-grade serous ovarian cancers, the team’s research focus has now shifted towards targeted risk-reducing salpingectomies. The hope is that this will greatly reduce mortality and morbidity from HGSC by delivering a targeted procedure that is catered to an individual’s risk profile. This work will further refine the current standard of care in ovarian cancer prevention by taking risk into account for each individual patient, thus allowing for personalized preventative care.
Hanley, G. E., Pearce, C. L., & Talhouk , A., et al (2022). Outcomes From Opportunistic Salpingectomy for Ovarian Cancer Prevention. JAMA Netw Open, 5(2). https://doi.org/ 10.1001/jamanetworkopen.2021.47343
McAlpine, J. N., Hanley, G. E., Woo, M. M., Tone, A. A., Rozenberg, N., Swenerton, K. D., Gilks, C. B., Finlayson, S. J., Huntsman, D. G., Miller, D. M., & Ovarian Cancer Research Program of British Columbia (2014). Opportunistic salpingectomy: uptake, risks, and complications of a regional initiative for ovarian cancer prevention. American journal of obstetrics and gynecology, 210(5), 471.e1–471.e4711. https://doi.org/10.1016/j.ajog.2014.01.003
Hanley, G. E., Kwon, J. S., Finlayson, S. J., Huntsman, D. G., Miller, D., & McAlpine, J. N. et al (2018). Extending the safety evidence for opportunistic salpingectomy in prevention of ovarian cancer: a cohort study from British Columbia, Canada. American journal of obstetrics and gynecology, 219(2), 172.e1–172.e8. https://doi.org/10.1016/j.ajog.2018.05.019
Hanley, G. E., Kwon, J. S., McAlpine, J. N., Huntsman, D. G., Finlayson, S. J., & Miller, D. et al (2020). Examining indicators of early menopause following opportunistic salpingectomy: a cohort study from British Columbia, Canada. American Journal of Obstetrics and Gynecology, 223(2). https://doi.org/10.1016/j.ajog.2020.02.005
Kwon, J. S., McAlpine, J. N., Hanley, G. E., Finlayson, S. J., Cohen, T., Miller, D. M., Gilks, B. C., & Huntsman, D. G. (2015). Costs and Benefits of Opportunistic Salpingectomy as an Ovarian Cancer Prevention Strategy. American College of Obstetricians and Gynecologists, 125(2). https://doi.org/10.1097/AOG.0000000000000630
Hanley, G. E., Niu, J., Han, J., Fung, S., Bryant, H., Kwon, J. S., Huntsman, D. G., Finlayson, S. J., McAlpine, J. N., Miller, D., & Earle, C. C. (2022). Opportunistic salpingectomy between 2011 and 2016: a descriptive analysis. CMAJ Open, 10(2). https://doi.org/https://doi.org/10.9778/cmajo.20210219
Ntoumanoglou-Schuiki, A., Tomasch, G., Laky, R., Taumberger, N., Bjelic-Radisic, V., & Tamussino, K. (2018). Opportunistic prophylactic salpingectomy for prevention of ovarian cancer: What do national societies advise? European Journal of Obstetrics & Gynecology and Reproductive Biology, 225, 110–112. https://doi.org/10.1016/j.ejogrb.2018.03.043
White Coat, Black Arts Podcast on OS
Beyond the Stories: OS for Ovarian Cancer Prevention
New York Times Article
on OS
GCI Rounds: OS During Caesarean Section
Read about our other research
Check out our comprehensive list of research from GCI to see what interests you