Opportunistic Bilateral Salpingectomy and Ovarian Cancer

Opportunistic Bilateral Salpingectomy - Does it Help Reduce the Risk of Ovarian Cancer?

Opportunistic Bilateral Salpingectomy and Ovarian Cancer

Opportunistic Bilateral Salpingectomy: Does It Reduce The Risk of Ovarian Cancer?

Ovarian cancer is a lethal disease that affects thousands of women worldwide. It is often difficult to detect in its early stages, leading to high mortality rates. However, recent advancements in research into the origins of ovarian cancer have highlighted a promising preventive measure known as opportunistic bilateral salpingectomy. Dr Kent Kuswanto sheds more light on what the operation entails and how it can effectively reduce the risk of ovarian cancer.

Understanding Opportunistic Bilateral Salpingectomy

Opportunistic bilateral salpingectomy refers to the surgical removal of both fallopian tubes during other gynaecological procedures, such as hysterectomy or tubal sterilisation. The procedure takes advantage of the opportunity presented by these surgeries to proactively reduce the risk of ovarian cancer. It has gained attention due to emerging evidence suggesting that many cases of ovarian cancer originate in the fallopian tubes.

The Link Between Fallopian Tubes and Ovarian Cancer

Traditionally, past research in the field found the ovaries to be the primary site of ovarian cancer development. However, recent studies have revealed that the fallopian tubes may play a crucial role. Research has shown that a significant number of high-grade serous ovarian cancers, the most common and aggressive subtype, actually originate in the fallopian tubes. This understanding has paved the way for interventions like opportunistic bilateral salpingectomy.

Although many types of ovarian cancers may derive from the fallopian tube, it is important to remember that some types of ovarian cancer still primarily arise from the ovary itself. Therefore, although opportunistic salpingectomy offers the opportunity to significantly decrease the risk of ovarian cancer, it does not eliminate the risk of ovarian cancer entirely. 

Mechanisms of Risk Reduction

Opportunistic bilateral salpingectomy offers several mechanisms through which it reduces the risk of ovarian cancer:

  1. Removal of the potential origin: By removing the fallopian tubes, which are recognized as the site of origin for many cases of high-grade serous ovarian cancer, the procedure eliminates the potential source of cancer development. This preventive measure significantly reduces the risk of developing ovarian cancer.
  2. Elimination of Precursor Lesions: Certain precancerous lesions, such as serous tubal intraepithelial carcinoma (STIC), have been found in the fallopian tubes of women with ovarian cancer. The surgery removes these precancerous lesions, effectively eliminating the possibility of their progression to ovarian cancer.
  3. Disruption of Cancer Pathways: Some theories suggest that fallopian tubes may contribute to the development of certain types of ovarian cancer through retrograde menses. By removing the fallopian tubes, opportunistic bilateral salpingectomy disrupts these pathways, reducing the likelihood of cancer formation.


Considerations and Benefits

Opportunistic bilateral salpingectomy offers several benefits as a risk-reducing strategy:

  1. Feasibility and Safety: The procedure can be safely performed during other gynaecological surgeries without significantly prolonging the duration of procedure or increasing the risk of complications 
  2. Preserving Ovarian Function: Unlike risk-reducing salpingo-oophorectomy, which involves removing both the fallopian tubes and ovaries, opportunistic bilateral salpingectomy preserves ovarian function. This is particularly relevant for premenopausal women who may still require hormonal production from the ovaries.
  3. Applicability to High-Risk Individuals: The procedure is particularly valuable for women at high risk of developing ovarian cancer due to genetic factors or personal history. It offers a proactive approach to risk reduction in this vulnerable population.


Opportunistic bilateral salpingectomy is an emerging preventive measure that shows promise in reducing the risk of ovarian cancer. For further medical advice on this procedure, you should consult your local doctor or seek a referral to a gynaecologist. Contact Dr Kent Kuswanto today to get a consultation appointment.