Costs and Benefits of Opportunistic Salpingectomy as an Ovarian Cancer Prevention Strategy

Abstract

Salpingectomy with hysterectomy for benign conditions will reduce ovarian cancer risk at acceptable cost and is a cost-effective alternative to tubal ligation for sterilization. Opportunistic salpingectomy should be considered for all women undergoing these surgical procedures.

Ovarian Cancer Prevention in High-risk Women

“…Salpingectomy with delayed oophorectomy has been proposed as an alternative to RRSO in order to postpone the onset of premature menopause and its effect on non-cancer menopause-related morbidity and quality of life(116). Modeling of the cost-effectiveness of this approach demonstrated acceptability and a survey of previvors and key stakeholders demonstrated interest and acceptability of this approach (117, 118). Several prospective studies are in various phases of development and patient accrual (119, 120).…”

Fallopian Tube Ligation or Salpingectomy as Means for Reducing Risk of Ovarian Cancer

“…Both of these statements were more conservative than the proposed plan of the British Columbia Ovarian Cancer Research Group program, instituted in 2010, which involved performing opportunistic salpingectomy with benign hysterectomy or in lieu of bilateral tubal ligation for permanent contraception. These authors suggested that this approach would yield a 20–40 percent population risk reduction for ovarian cancer over the next 20 years [14]. …”

“…The estimated risk reduction for any individual person undergoing opportunistic salpingectomy is up to 50 percent [14]. Although this is an appreciable benefit, it must be tempered with a reminder that women at population risk of ovarian cancer have only a 1:70 or 1.4 percent lifetime risk [14].…”

“…Although this is an appreciable benefit, it must be tempered with a reminder that women at population risk of ovarian cancer have only a 1:70 or 1.4 percent lifetime risk [14]. The significant benefits of opportunistic salpingectomy, besides the risk reduction, are the ease and speed of the procedure, the rarity of complications, the convenience of removing the specimen, and the fact that surgical removal is theoretically the only way to permanently reduce the risk of ovarian cancer [15] (although bilateral tubal ligation without salpingectomy has also been associated with decreased risk [16]).…”

The Fallopian Tube: From Back Stage to Center Stage

“…They estimated that use of BS in this fashion would reduce the risk of ovarian cancer by 38% and 29% when employed with hysterectomy or instead of tubal ligation, respectively (24). They conclude that “opportunistic salpingectomy should be considered for all women undergoing these surgical procedures.”…”