Salpingectomy for ectopic pregnancy reduces ovarian cancer risk—a nationwide study

Abstract

Recent studies propose fallopian tubes as the tissue origin for many ovarian epithelial cancers. To further support this paradigm, we assessed whether salpingectomy for treating ectopic pregnancy had a protective effect using the Taiwan Longitudinal National-Health-Research Database. We identified 316,882 women with surgical treatment for ectopic pregnancy and 3,168,820 age- and index-date-matched controls from 2000-2016. In a nested cohort, 91.5% of cases underwent unilateral salpingectomy, suggesting that most surgically managed patients have salpingectomy. Over a follow-up period of 17 years, the ovarian carcinoma incidence was 0.0069 (95%CI : 0.0060-0.0079) and 0.0089 (95%CI : 0.0086-0.0092) in the ectopic pregnancy and the control groups, respectively (p < .001). After adjusting the events to per 100-person years, the hazard ratio in the ectopic pregnancy group was 0.70 (95%CI : 0.61-0.80). The risk reduction occurred only in epithelial ovarian cancer (HR : 0.73, CI : 0.63-0.86) and not in non-epithelial subtypes. These findings show a decrease in ovarian carcinoma incidence following salpingectomy for treating ectopic pregnancy.