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Opportunistic salpingectomy for ovarian, fallopian tubal, and peritoneal carcinoma risk reduction

Dianne M Miller, MD, FRCSC
Jessica N McAlpine, MD, FACOG, FRCPSC
Section Editors
Barbara Goff, MD
Howard T Sharp, MD
Deputy Editor
Sandy J Falk, MD, FACOG


Opportunistic salpingectomy is the removal of the fallopian tubes for primary prevention of epithelial carcinoma of the fallopian tube, ovary, or peritoneum in a woman undergoing pelvic surgery for another indication. This is an approach to prevention in women at average risk, rather than high risk, for these cancers. Women at high risk of ovarian cancer are typically advised to undergo risk-reducing salpingo-oophorectomy.

The preventive strategy of opportunistic salpingectomy was introduced in the 2010s. This was based on data regarding the role of fallopian tube in the development of what had previously been presumed to be primary ovarian cancers, as a site of primary carcinogenesis or a conduit for neoplastic cells or carcinogens.

Opportunistic salpingectomy for ovarian, tubal, and peritoneal carcinoma risk reduction in average-risk women is reviewed here. Risk-reducing salpingo-oophorectomy for women at high risk of carcinoma of the ovary, fallopian tube, or peritoneum and the pathogenesis of serous carcinoma of the ovary, tube, and peritoneum are discussed separately. (See "Risk-reducing bilateral salpingo-oophorectomy in women at high risk of epithelial ovarian and fallopian tubal cancer" and "Pathogenesis of ovarian, fallopian tubal, and peritoneal serous carcinomas".)


Ovarian cancer is a disease with a poor prognosis and limited options in terms of screening, diagnosis, and treatment. Ovarian cancer is the second most common type of gynecologic malignancy and the most common cause of death from gynecologic cancer. It is the fifth most common cause of cancer deaths in women. In the United States and Canada every year, over 25,000 women are newly diagnosed with ovarian cancer, and 16,000 women die from the disease [1]. (See "Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Epidemiology and risk factors", section on 'Epidemiology'.)

Ovarian cancer typically presents at an advanced stage and has a poor prognosis (table 1 and table 2). Unfortunately, there are few current approaches to improve clinical outcomes for ovarian cancer. There are no effective screening tests. For women who present with symptoms suggestive of ovarian cancer or with an adnexal mass, evaluation with serum biomarkers and/or pelvic imaging has a low specificity, and many women with a benign adnexal mass undergo unnecessary surgery (in one study, ovarian cancer was found in only 3.5 percent of procedures performed for a suspicious adnexal mass [2]) [3-6]. (See "Screening for ovarian cancer" and "Approach to the patient with an adnexal mass".)


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