Population-Level Reduction in Ovarian Cancer Through Performance of Opportunistic Salpingectomy at the Time of Cholecystectomy.

Abstract

We estimated the population-level magnitude of reduction in incident ovarian cancer if opportunistic salpingectomy (OS) was implemented at the time of cholecystectomy (CCK). Opportunistic salpingectomy (OS), prophylactic removal of the fallopian tubes, is a primary prevention strategy to reduce the risk of ovarian cancer. We developed a methodological framework to estimate the benefit of OS-CCK for women. Population-level statistics were used to estimate the number of CCKs performed annually in the U.S. as well as the expected number of ovarian cancers, while accounting for competing risks of death. OS reduces the risk of ovarian cancer by 65%. We simulated the effect on ovarian cancer for up to 50 years if OS was performed in 40-80% of women undergoing CCK. Implementation of OS in 40% of the CCKs women 40-44 years of age would prevent 6 cases of ovarian cancer within 5 years of follow-up, 41 cases within 20 years and 139 cases after 50 years of follow-up. If OS were performed in 80% of CCKs in this population, the corresponding cases prevented rises to 12 at 5 years, 81 at 20 years and 279 after 50 years follow-up. If OS were performed in 40% of all women ≥40 years of age who underwent CCK in given year, there would be 111 cases of ovarian cancer prevented after 5 years, 349 cases after 15 years, 660 cases after 30 years and 850 lifetime cases prevented. OS at the time of cholecystectomy has the potential to significantly reduce the burden of ovarian cancer in the United States.