David Shalowitz, MD, on spreading awareness of salpingectomy for cancer prevention

The value of ACOG's clinical practice update on opportunistic salpingectomy lies partly in spreading awareness across clinical specialties, but its implementation demands careful, individualized surgical planning, according to David Shalowitz, MD, MSHP, Director, Cancer Care Delivery, Corewell Health, Grand Rapids, Michigan, and co-author of the update. The discussion continues Shalowitz's remarks on cross-specialty collaboration to expand salpingectomy access.

Shalowitz encouraged clinicians to review the full update, noting the complexity involved in applying salpingectomy across varied clinical scenarios.

“There's certainly a lot of complexity in implementing salpingectomy in any of the clinical circumstances that we highlight, including the postpartum setting, in settings where patients desire permanent contraception, and particularly tubal surgery to achieve permanent contraception,” he said.

Shared decision-making at the center

Shalowitz emphasized that the procedure is not universally appropriate and must reflect individual patient circumstances.

“We would encourage patients to talk to their gynecologists about whether and when there might be an opportunity to remove the fallopian tubes to prevent ovarian cancer in the future. And it's certainly the case that this procedure may not be the right fit for everyone,” he said. “All surgical planning should be done in the context of shared decision-making, so that the procedure and the route of procedure chosen are consistent with both the clinical situation as well as patients' values and preferences.”

A cross-specialty prevention message

Shalowitz framed the update as an opportunity to reach beyond gynecology, including primary care clinicians and anyone whose practice involves cancer prevention.

“Although this is about a gynecologic cancer, from the perspective of a gynecologic oncologist, what's most important is to try to make it so that patients never need to come see me for an ovarian cancer,” he said, calling first-line clinicians “absolutely critical” to ensuring patients are aware of the option.

He reiterated that salpingectomy is an option for patients considering permanent contraception or undergoing common surgeries that already access the abdominal or pelvic peritoneum.

Per the ACOG update, the fallopian tube is the origin of most high-grade serous carcinomas, and salpingectomy adds 10 minutes or less to a procedure without added surgical risk. A British Columbia cohort found a 78% relative reduction in lifetime ovarian cancer risk (HR 0.22; 95% CI, 0.05–0.95), and ovarian cancer accounted for an estimated 20,890 cases and 12,730 deaths in 2025.

Reference:

Fitch J. David Shalowitz, MD, on cross-specialty collaboration to expand salpingectomy access. Contemporary OB/GYN. Published September 2026. Accessed September 14, 2026. https://www.contemporaryobgyn.net/view/david-shalowitz-md-cross-specialty-collaboration-salpingectomy