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Risk-Reducing (Prophylactic) Salpingectomy

September 10, 2019

Health Problem: In the United States, ovarian cancer ranks fifth among cancer deaths. This type of cancer is often not detected at an early stage since early signs or symptoms are usually absent or easily overlooked. There is no effective method for screening women at normal risk for ovarian cancer.

Technology Description: Bilateral salpingectomy refers to the preventive surgical removal of both fallopian tubes with the goal of reducing the risk of ovarian cancer in women at normal risk of the disease. Although salpingectomy can be performed alone as a substitute for tubal ligation, it is usually performed opportunistically as an adjunct to another planned gynecologic or obstetric surgery such as hysterectomy or cesarean section. Prophylactic salpingectomy (also referred to as opportunistic salpingectomy) has been performed during open, laparoscopic, and vaginal hysterectomy.

Controversy: The long-term consequences of prophylactic salpingectomy have not been studied, and the risk of developing ovarian cancer is normally low. If this procedure consistently causes an unanticipated increase in surgical risk or some other health problem, the risks of salpingectomy could outweigh the benefits of ovarian cancer prevention.

Key Questions:

  • Does prophylactic salpingectomy reduce the incidence of ovarian cancer?
  • Does salpingectomy provide greater benefit than other surgical interventions, such as tubal ligation?
  • Does salpingectomy pose any health risks?
  • Have definitive patient selection criteria been established for use of salpingectomy to reduce the incidence of ovarian cancer?