Canadian Strategy Dramatically Reduces Most Lethal Ovarian Cancer Risk
A prevention strategy developed by Canadian researchers can reduce the risk of the most common and lethal form of ovarian cancer by nearly 80 percent, according to a new study. The findings were published in JAMA Network Open by researchers at the University of British Columbia (UBC).
Strategy Overview
The strategy, known as opportunistic salpingectomy (OS), involves the removal of a person's fallopian tubes when they are already undergoing routine gynecological surgery, such as hysterectomy or tubal ligation. The Canadian province of British Columbia (B.C.) began offering OS in 2010.
Researchers from UBC, BC Cancer, and Vancouver Coastal Health designed this approach following the discovery that most ovarian cancers originate in the fallopian tubes rather than the ovaries. OS maintains a person's ovaries, preserving hormone production and minimizing side effects from the additional procedure.
Study Results
The new study, led by the B.C.-based Ovarian Cancer Observatory, provides evidence that the Canadian innovation contributes to saving lives.
"Removing fallopian tubes as an add-on during routine surgery can help prevent the most lethal type of ovarian cancer."
– Dr. Gillian Hanley, associate professor of obstetrics and gynecology at UBC and co-senior author.
Ovarian cancer is a significant gynecological cancer, with approximately 3,100 Canadians diagnosed and 2,000 deaths annually. There is no currently reliable screening test for ovarian cancer, which often leads to diagnoses at advanced stages when treatment options are limited and survival rates are low.
The OS approach was developed by Dr. Dianne Miller, an associate professor emerita at UBC and a gynecologic oncologist. Dr. Miller is a co-founder of B.C.'s ovarian cancer research team, OVCARE.
This study is the first to quantify the reduction in risk for serous ovarian cancer, the most common and deadly subtype of the disease, due to OS. Previous research established OS as safe, without reducing the age of menopause onset, and cost-effective for health systems.
Researchers analyzed population-based health data for over 85,000 individuals who underwent gynecological surgeries in B.C. between 2008 and 2020. They compared rates of serous ovarian cancer between those who had OS and those who had similar surgeries without the procedure. Individuals who had OS were 78 percent less likely to develop serous ovarian cancer. In cases where ovarian cancer occurred after OS, the cancers were found to be less biologically aggressive. Data collected from pathology laboratories globally supported these findings.
Global Adoption and Future
Since its introduction in B.C. in 2010, OS has seen widespread adoption, with approximately 80 percent of hysterectomies and tubal ligation procedures in the province now incorporating fallopian tube removal. Globally, professional medical organizations in 24 countries, including the Society of Obstetrics and Gynaecology of Canada since 2015, recommend OS as an ovarian cancer prevention strategy.
Dr. David Huntsman, professor of pathology and laboratory medicine and obstetrics and gynecology at UBC and a distinguished scientist at BC Cancer, noted that the reported impact of OS exceeded expectations.
Researchers suggest that expanding the global adoption of OS could prevent thousands of ovarian cancer cases worldwide each year. B.C. has also expanded OS to routine surgeries performed by general and urologic surgeons, aiming to increase the number of individuals who could benefit.
"Not offering this surgical add-on may leave patients unnecessarily vulnerable to this cancer."
– Dr. David Huntsman