Prevent Cancer Foundation’s statement on ACOG guidelines for ovarian cancer prevention
The American College of Obstetricians and Gynecologists (ACOG) recently released recommendations that more strongly support the removal of a patient’s fallopian tubes to reduce ovarian cancer risk (in those assigned female at birth).
The removal of both fallopian tubes is called a bilateral salpingectomy; when the tubes are removed during another, unrelated surgery, it’s known as an opportunistic salpingectomy.
ACOG’s updated guidelines explain that many common abdominal and pelvic procedures—including a hysterectomy (surgical removal of the uterus), tubal procedures for permanent contraception and even some non-gynecologic surgeries—offer opportunities to reduce a person’s risk of ovarian cancer through salpingectomy.
Once the fallopian tubes are removed, the patient cannot conceive without the help of in vitro fertilization (IVF), a procedure where an embryo is implanted directly in the uterus.
ACOG recommends OB‑GYNs perform salpingectomy under the following circumstances:
- During a hysterectomy: OB-GYNs should routinely perform bilateral salpingectomy when patients undergo removal of the uterus.
- During other pelvic or abdominal surgeries: For patients who are done having children, OB‑GYNs should recommend bilateral salpingectomy during non-hysterectomy gynecologic surgeries that enter the peritoneal cavity.
- During eligible non-gynecologic procedures: OB-GYNs should support other surgical specialists in offering opportunistic salpingectomy when appropriate.
“We now understand that many ovarian cancers begin in the fallopian tubes, giving us an important opportunity to prevent cancer before it develops,” said Kathleen Schmeler, Professor of Gynecologic Oncology and Reproductive Medicine at the University of Texas MD Anderson Cancer Center and member of the Foundation’s Consejo Asesor Médico. “Opportunistic salpingectomy allows us to turn our growing understanding of ovarian cancer into prevention, substantially reducing a woman’s future risk while preserving the ovaries and their important hormonal function. It is a powerful example of how we can shift our approach from diagnosing and treating cancer to preventing it whenever we have the opportunity.”
There is no recommended routine screening for ovarian cancer for people at average risk, meaning opportunities are rare to detect and diagnosis ovarian cancer in early stages. Only about 20% of ovarian cancers are found at an early stage, but when it is found early, the five-year survival rate is 94%.
The Prevent Cancer Foundation encourages people with ovaries to talk with their health care provider about their personal risk for ovarian cancer and discuss steps to reduce their risk when possible. Depending on your situation, your health provider may recommend screening tests used for those at high risk, medications or surgery.
These updated recommendations are grounded in data that show most ovarian cancers originate in the fallopian tubes, not the ovaries. Removing both tubes can reduce a patient’s lifetime risk of ovarian cancer by up to 78%, without affecting hormone production or ovarian function.
Clinical studies also indicate salpingectomy is as safe as tubal ligation (a permanent surgical birth control method where a doctor cuts, ties or seals the fallopian tubes to prevent pregnancy), adds very little time to the surgery, and does not increase short- or long-term risks.
In some cases, it may be beneficial for people at higher risk for ovarian cancer to undergo a salpingo-oophorectomy, which is the removal of the ovaries and fallopian tubes. People at higher risk may include those with:
- A known genetic mutation (such as BRCA1, BRCA2 o Lynch syndrome) associated with increased breast or ovarian cancer risk
- A strong family history of ovarian, mama o colorectal cancers
- No personal history of giving birth
- Endometriosis (abnormal growth of tissue that lines the inside of the uterus)
- Radiation exposure to the pelvis
- A menstrual cycle that started before age 12
- Menopause that started after age 52
The Prevent Cancer Foundation encourages everyone to know their historia de salud familiar, understand their personal risk factors and talk with their health care provider about ways to reduce cancer risk.