Innovation cuts ovarian cancer risk by nearly 80%

A surgical procedure developed in Canada reduces the risk of the most common and deadly form of ovarian cancer by nearly 80 per cent.

The strategy, known as opportunistic salpingectomy (OS), removes the fallopian tubes during routine gynaecological surgery such as hysterectomy (womb removal) or tubal ligation (having one’s tubes tied).

The study analysed population health data for more than 85,000 people who had gynaecological surgeries in British Columbia between 2008 and 2020, comparing rates of serous ovarian cancer with those who had similar operations without the procedure.

Researchers at the University of British Columbia found that people who had opportunistic salpingectomy were 78 per cent less likely to develop serous ovarian cancer, the most common and deadly subtype.

In the rare cases where ovarian cancer occurred after the procedure, those cancers were found to be less biologically aggressive.

Co-senior author Gillian Hanley is an associate professor of obstetrics and gynaecology at the University of British Columbia.

She said: “This study clearly demonstrates that removing the fallopian tubes as an add-on during routine surgery can help prevent the most lethal type of ovarian cancer,.

“It shows how this relatively simple change in surgical practice can have a profound and life-saving impact.”

British Columbia became the first jurisdiction in the world to offer opportunistic salpingectomy in 2010, after researchers discovered that most ovarian cancers originate in the fallopian tubes rather than the ovaries.

The procedure leaves the ovaries in place, preserving hormone production so side effects are minimal.

The approach was initially developed by Dianne Miller, an associate professor emerita at the University of British Columbia and gynaecological oncologist with Vancouver Coastal Health and BC Cancer.

“If there is one thing better than curing cancer it’s never getting the cancer in the first place,” said Miller.

Since its introduction in British Columbia in 2010, opportunistic salpingectomy has been widely adopted, with approximately 80 per cent of hysterectomies and tubal ligation procedures in the province now including fallopian tube removal.

Professional medical organisations in 24 countries now recommend the procedure as an ovarian cancer prevention strategy, including the Society of Obstetrics and Gynaecology of Canada, which issued guidance in 2015.

“This is the culmination of more than a decade of work that started here in B.C.,” said co-senior author David Huntsman, professor of pathology and laboratory medicine and obstetrics and gynaecology at the University of British Columbia.

“The impact of OS that we report is even greater than we expected.”

British Columbia recently became the first province to expand opportunistic salpingectomy to routine surgeries performed by general and urological surgeons through a project supported by the Government of British Columbia and Doctors of BC.