Extract

Accumulated evidence over the past 10 years has strongly indicated that the fallopian tube is the site of origin for many high-grade serous carcinomas ( 1 ), which represent 50% to 60% of all epithelial ovarian cancers. This multi-origin model of ovarian cancer development has important implications for prevention of ovarian cancer: if some or all high-grade serous tumors develop in the fallopian tube, then bilateral salpingectomy could prevent this most aggressive form of ovarian cancer. However, to date, no large-scale data regarding the impact of salpingectomy on ovarian cancer incidence have been available. The article by Falconer et al. ( 2 ) is the first to address this question. This study combined data from several population registries in Sweden to compare incidence of ovarian cancer in women with a previous gynecologic procedure for benign indications (salpingectomy, tubal ligation, total abdominal hysterectomy with bilateral salpingo-oophorectomy [BSO], and hysterectomy without concomitant bilateral salpingo-oophorectomy [TAH]) to women with no history of these surgeries. They reported a statistically significant 35% lower risk of ovarian cancer among women with a previous salpingectomy compared with women with no previous surgeries. Consistent with previous studies, all other gynecologic surgeries evaluated in this study were associated with lower ovarian cancer risk, ranging from a 21% lower risk associated with TAH to a 94% lower risk with BSO.

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