Ovarian cancer has a very poor prognosis, with a five-year survival rate of around 30-40%. As progress in treatment options for ovarian cancer is slow, and effective screening methods are lacking, primary prevention is crucial. Research shows that the most common type of ovarian cancer, high-grade serous ovarian carcinoma, originates in the fallopian tubes (hereafter referred to as tubo-ovarian carcinoma). The function of the fallopian tubes is limited to enabling pregnancy. Therefore, (preventive) removal of the fallopian tubes can lead to a significant reduction in the incidence of ovarian cancer: studies show a risk reduction of 50–80% for developing ovarian cancer later in life.

In the general female population, the lifetime risk of developing ovarian cancer is approximately 1.3%. This risk is too low to justify surgery solely for the purpose of removing the fallopian tubes. The risks associated with surgery would outweigh the potential benefit of reducing tubo-ovarian carcinoma risk. However, when women undergo an elective intra-abdominal surgery for another indication, the fallopian tubes could be removed simultaneously. The removal of the fallopian tubes, while preserving the hormone-producing ovaries, during a planned abdominal procedure is called opportunistic salpingectomy (OS).

STOPOVCA (STOP OVarian CAncer)

In our previous study, the STOPOVCA project, we improved the implementation of OS during gynecological surgeries in the Netherlands, as there was significant practice variation between centers.

As part of this project, a decision aid was developed to support healthcare providers and women in making an informed choice about whether or not to have the fallopian tubes removed during a gynecological procedure or sterilization. Research showed that with this decision aid and other tailored strategies, the variation in practice between centers decreased. Women found the decision aid to be highly valuable, and more than 90% of them opted for OS.

To further reduce the incidence of tubo-ovarian carcinoma, the next step is that OS is also offered during non-gynecological abdominal surgeries.

STOPOVCA 2.0 (STOP OVarian CAncer 2.0)