David Shalowitz, MD, on cross-specialty collaboration to expand salpingectomy access

Obstetrician-gynecologists have an opportunity to reduce ovarian cancer risk beyond their own operating rooms by collaborating with non-gynecologic surgeons who access the peritoneal cavity, according to David Shalowitz, MD, MSHP, Director, Cancer Care Delivery, Corewell Health, Grand Rapids, Michigan, and co-author of ACOG's clinical practice update. The discussion continues Shalowitz's remarks on the strengthened evidence behind salpingectomy for ovarian cancer prevention.

Shalowitz framed cross-specialty collaboration as central to prevention for a disease that lacks effective screening and is difficult to catch early.

“We want to be sure that we, as obstetrician-gynecologists, maintain as collaborative a relationship as possible with non-gynecologic surgical specialists, especially when there's an opportunity to reduce patients' risk for a disease that we cannot screen for at the moment and that we're having a lot of trouble detecting at an early stage,” he said, noting that at least three-quarters of ovarian cancers present already metastatic.

Opportunities during other abdominal surgeries

Shalowitz pointed to procedures that already provide access to the abdomen or pelvis as prevention opportunities.

“In patients who are having their gallbladder removed or undergoing bariatric surgery or colorectal surgery, we can offer patients the opportunity to have their personal risk of ovarian cancer decreased by nearly 80%, with minimal increased time in the operating room and no additional risk of surgical complications,” he said.

He noted that non-gynecologic surgeons and primary care clinicians who may not follow the ovarian cancer literature are often eager for prevention opportunities, and that ob-gyns can serve as a source of information to guide counseling.

Counseling and technical support

Shalowitz emphasized that salpingectomy is only appropriate for patients who do not desire future fertility, making counseling essential.

“For anybody who's counseling patients about removal of the fallopian tubes to reduce the risk of cancer, it's important to also ensure that patients are well counseled about the fertility implications of having those fallopian tubes removed,” he said.

“There is also an opportunity, as needed, to provide technical assistance in the operating room to surgeons who may not be familiar with operating on the gynecologic organs,” Shalowitz said, noting that removing the fallopian tubes is generally not a complicated process and that surgical teaching aids exist alongside opportunities for in-person collaboration.

Per the ACOG update, the fallopian tube is the origin of most high-grade serous carcinomas, and salpingectomy adds approximately 10 minutes or less to a procedure without added surgical risk, supporting its use across obstetric, gynecologic, and nongynecologic surgeries within shared decision-making.¹

Reference:

1. Fitch J. David Shalowitz, MD, on strengthened evidence behind salpingectomy for ovarian cancer prevention. Contemporary OB/GYN. Published September 2026. Accessed September 8, 2026. https://www.contemporaryobgyn.net/view/david-shalowitz-md-strengthened-evidence-behind-salpingectomy-cancer