Feb. 10, 2023 — All women who have finished having children should consider having their fallopian tubes removed at the time of other scheduled pelvic surgery in order to lower their risk of developing ovarian cancer, even if they aren’t at increased risk for the deadly disease, a leading research organization has advised.
Doctors currently recommend that women with high genetic risk for ovarian cancer have their ovaries and fallopian tubes removed once they’ve finished having children.
In new messaging, the Ovarian Cancer Research Alliance is now encouraging all women, even those without a genetic mutation, to have their fallopian tubes removed during a planned gynecologic surgery.
There is increasing evidence that many types of ovarian cancers start in the fallopian tube, and fallopian tube removal has been shown to dramatically reduce risk for a later diagnosis, the organization said.
The new advice replaces the decades old focus on symptom awareness and early detection of ovarian cancer through screening.
It follows a “sobering and deeply disappointing” study that showed that regular screening for ovarian cancer with blood tests and ultrasound does not save lives, the organization said. (This was the UK Collaborative Trial of Ovarian Cancer Screening published in the journal The Lancet in June 2021).
The results of that study were “very hard to accept,” Audra Moran, OCRA president and CEO, says in an interview.
“We have an obligation to let people know that symptom awareness and early detection will not save lives,” but preemptive removal of the fallopian tubes “absolutely will,” Moran says.
This advice is “reasonable and makes sense,” says Stephanie V. Blank, MD, president of the Society of Gynecologic Oncology and director of gynecologic oncology for the Mount Sinai Health System in New York.
And it’s actually not new, she says. Several years ago, the Society of Gynecologic Oncology said fallopian tube removal may be “an appropriate and feasible” strategy for ovarian cancer risk reduction.
“It’s getting new attention” now based on the disappointing screening study, Blank says.
Importantly, the recommendation is for women who are already scheduled for another pelvic surgery for a benign condition, such as hysterectomy for fibroids. There is no current recommendation to have fallopian tubes removed as a standalone procedure.
Deanna Gerber, MD, gynecologic oncologist at NYU Langone Perlmutter Cancer Center-Long Island, says women should understand that there is still ongoing research on this topic, “but this low-risk procedure may reduce their risk of developing an ovarian or fallopian tube cancer.”
As part of their new messaging campaign, the Ovarian Cancer Research Alliance is also encouraging women to know their personal risk for ovarian cancer. The group has launched a pilot program offering free at-home genetic testing kits to people with a personal or family history of breast, ovarian, uterine, or colorectal cancer.
In the United States, ovarian cancer ranks fifth in cancer deaths among women and causes more deaths than any other gynecological cancer, according to the American Cancer Society.
Often, the symptoms are subtle, making ovarian cancer difficult to detect in its early stages. Common symptoms include bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and needing to urinate more frequently.