ACOG supports salpingectomy for ovarian cancer prevention

Women at risk of ovarian cancer and who are undergoing hysterectomy should be counseled about the possible benefits of salpingectomy, according to a new committee opinion from the American College of Obstetricians and Gynecologists (ACOG). The discussion, however, should not influence the choice of surgical approach for hysterectomy or for sterilization.

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ACOG Committee Opinion Number 620 underscores the high mortality rate of ovarian cancer, which is the fifth leading cause of cancer deaths in women, and the lack of effective diagnostics for the disease. Researchers theorize that retrograde menses may cause endometrioid and clear cell carcinomas of the ovary, hence the potentially protective effect of salpingectomy.

The authors of the Committee Opinion note the safety of salpingectomy, the lack of impact of the procedure on ovarian function, and the value of discussing bilateral salpingectomy as a method of contraception. They also emphasize the need for randomized controlled trials to validate a reduction in incidence of ovarian cancer as a result of salpingectomy in selected patients.

In concluding, the authors indicate that “the approach to hysterectomy or sterilization should not be influenced by the theoretical benefit of salpingectomy. Surgeons should continue to observe and practice minimally invasive techniques. A vaginal hysterectomy should not be changed to a laparoscopic hysterectomy simply to perform a salpingectomy.”

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