A prevention strategy developed by\u00a0Canadian\u00a0researchers\u00a0can reduce\u00a0the risk of the most common and deadly form of ovarian cancer by\u00a0nearly 80\u00a0per cent, according to a new study published today in\u00a0JAMA Network Open\u00a0by researchers at the University of British Columbia (UBC).\u00a0<\/p>\n
The strategy, known as opportunistic salpingectomy\u00a0(OS), involves\u00a0proactively\u00a0removing\u00a0a person’s\u00a0fallopian tubes\u00a0when they are already undergoing a\u00a0routine gynecological surgery\u00a0such as hysterectomy or\u00a0tubal ligation, commonly called “having one’s tubes tied”.\u00a0<\/p>\n
The Canadian province of British Columbia (B.C.)\u00a0became the first jurisdiction in the world to offer OS in 2010, after a team of researchers from UBC, BC Cancer and Vancouver Coastal Health designed the approach when it was discovered that\u00a0most ovarian cancers originate in the fallopian tubes rather than the ovaries. OS leaves a person’s ovaries intact, preserving important hormone production so there are minimal side effects from the added procedure.\u00a0<\/p>\n
The new study, led by a B.C.-based international collaboration called the Ovarian Cancer Observatory, provides the clearest evidence yet that the Canadian innovation saves lives.\u00a0<\/p>\n
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This study clearly demonstrates that\u00a0removing the fallopian tubes\u00a0as an add-on during routine\u00a0surgery\u00a0can help\u00a0prevent the most lethal type of ovarian cancer. It shows how this\u00a0relatively\u00a0simple change in surgical practice can have a profound\u00a0and\u00a0life-saving impact.”\u00a0<\/p>\n
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Dr. Gillian Hanley, co-senior author, associate\u00a0professor of\u00a0obstetrics\u00a0and\u00a0gynecology\u00a0at\u00a0UBC<\/p>\n
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New hope against a deadly cancer\u00a0<\/p>\n
Ovarian cancer is the most lethal gynecological cancer. Approximately 3,100 Canadians are diagnosed with the disease each year and about 2,000 will die from it.\u00a0<\/p>\n
There is currently no reliable screening test for ovarian cancer, meaning that most cases are diagnosed at advanced stages when treatment options are limited and survival rates are low.\u00a0<\/p>\n
The OS approach was initially developed and named by Dr. Dianne Miller, an\u00a0associate professor emerita at\u00a0UBC and\u00a0gynaecologic oncologist\u00a0with\u00a0Vancouver Coastal Health and BC Cancer. She co-founded B.C.’s\u00a0multidisciplinary ovarian cancer research team, OVCARE.\u00a0<\/p>\n
“If there is one thing better than curing\u00a0cancer it’s never getting the\u00a0cancer in the first place,”\u00a0said Dr. Miller.\u00a0<\/p>\n
The new study is the first to quantify how much OS reduces the risk of serous ovarian cancer-the most common and deadly subtype of the disease. It builds on\u00a0previous\u00a0research\u00a0demonstrating\u00a0that OS is safe, does not reduce the age of menopause onset, and is cost-effective for health systems.\u00a0<\/p>\n
The study analyzed population-based health data for more than 85,000 people who underwent gynecological surgeries in B.C. between 2008 and 2020. The researchers compared rates of serous ovarian cancer between those who had OS and those who had similar surgeries but did not undergo the procedure.\u00a0<\/p>\n
Overall, people who had OS were 78 per cent less likely to develop serous ovarian cancer. In the rare cases where ovarian cancer occurred after OS, those cancers were found to be less biologically aggressive.\u00a0The findings were\u00a0validated\u00a0by data collected from pathology laboratories from around the world, which suggested a similar effect.\u00a0<\/p>\n
From B.C. innovation to global impact\u00a0<\/p>\n
Since its introduction in B.C. in 2010, OS\u00a0has been widely adopted,\u00a0with\u00a0approximately 80 per cent of hysterectomies and\u00a0tubal ligation\u00a0procedures in\u00a0the province\u00a0now\u00a0including\u00a0fallopian tube removal.\u00a0<\/p>\n
Globally, professional medical organizations in 24 countries now recommended OS as an ovarian cancer prevention strategy, including the Society of Obstetrics and gynecology of Canada, which issued guidance in 2015.\u00a0<\/p>\n
“This is the culmination of more than a decade of work that started here in B.C.,” said co- senior author Dr. David Huntsman, professor of pathology and laboratory medicine and obstetrics and gynecology at UBC and a distinguished scientist at BC Cancer. “The impact of OS that we report is even greater than we expected.”\u00a0<\/p>\n
The researchers say expanding global adoption of OS could prevent thousands of ovarian cancer cases worldwide each year.\u00a0<\/p>\n
Extending OS to other abdominal and pelvic surgeries where\u00a0appropriate could\u00a0further increase the number of people who could\u00a0benefit\u00a0from the prevention strategy. B.C. recently became the first province to expand OS to\u00a0routine surgeries performed by general and urologic surgeons\u00a0through a project supported by the Government of B.C. and Doctors of BC.\u00a0<\/p>\n
“Our hope is that more clinicians will adopt this proven approach, which has the potential to save countless lives,” said Dr. Huntsman. “Not offering this surgical add-on may leave patients unnecessarily vulnerable to this cancer.”\u00a0<\/p>\n
Source:<\/p>\n
University of British Columbia<\/a><\/p>\n Journal reference:<\/p>\n