When it comes to cancer prevention, we often imagine breakthrough drugs, expensive technology or years of scientific discovery. But one of the most promising ways to prevent ovarian cancer is already here. It’s simple, safe, takes just a few extra minutes in the operating room, and has the potential to save thousands of lives. So why aren’t we doing more of it?
Ovarian cancer is Canada’s deadliest gynecological cancer, killing approximately 2,000 people every year. Unlike breast or cervical cancer, there is no effective screening test. Symptoms are often vague, and most cases are diagnosed only after the cancer has spread, making treatment far more difficult and outcomes far worse.
For decades, ovarian cancer was believed to originate in the ovaries. But researchers have since shown this is a misnomer; many of the most common and aggressive forms of ovarian cancer actually begin in the fallopian tubes.
This change in understanding is now leading to calls to expand a surgical procedure developed by Canadian gynecologist Dianne Miller that is remarkably effective at preventing ovarian cancer.
The concept is straightforward. With a patient’s consent, surgeons remove the fallopian tubes as an add-on to a planned surgery. The ovaries are left intact so hormone production can continue and avoid triggering early menopause.
The additional surgical time is roughly five to 10 minutes while the additional risk is minimal.
Patients do not require longer hospital stays. And research has shown no meaningful increase in complications, infection rates or post-operative pain.
In other words, this quick and straight-forward procedure, called opportunistic salpingectomy, turns an already planned surgery into a chance to dramatically reduce ovarian cancer risk.
A recent study published by researchers at the University of British Columbia found opportunistic salpingectomy can reduce the risk of the most common and deadly forms of ovarian cancer by nearly 80 per cent.
Globally, professional societies in more than 20 countries now recommend opportunistic salpingectomy as a prevention strategy, including the Society of Obstetricians and Gynaecologists of Canada.
Yet, despite the evidence and international support, a major opportunity remains untapped.
Today, opportunistic salpingectomy is mostly offered during gynecological surgeries. But the next frontier lies in expanding this life-saving procedure to other abdominal and pelvic operations performed by general surgeons and urologists.
If a patient is already undergoing surgery in the abdomen or pelvis for another reason, why not consider whether the fallopian tubes can be removed safely at the same time?
The European Society of Gynaecological Oncology, American Cancer Society and the American College of Surgeons have all recently encouraged physicians to discuss performing tube removal with their patients at the time of other abdominal surgeries.
Here in Canada, British Columbia is leading the way. Through support from the provincial government and Doctors of BC, the province has expanded educational efforts beyond gynecologists to include general and urological surgeons. Ontario should take notice.
At North York General, we have begun training general surgeons and urologists so they understand the evidence, can identify appropriate patients, feel equipped to discuss the procedure with patients and can perform it safely. We are among the first hospitals in Ontario to systematically build this expertise across specialties. But individual hospitals can only do so much.
To truly realize the life-saving potential of opportunistic salpingectomy, provinces need to follow B.C.’s lead. That means funding education programs, virtual workshops, hands-on surgical training and cross-specialty collaboration. It means ensuring patients receive standardized information so they can ask informed questions about their options. And it means addressing practical barriers, including creating straightforward billing mechanisms to encourage this procedure.
We routinely embrace preventive measures when the evidence is compelling, including vaccinating against disease, screening for colon cancer and removing cataracts to preserve vision. Opportunistic salpingectomy deserves to be viewed through the same lens: a practical, evidence-based intervention that can prevent serious illness before it begins.
However, many patients have never heard of it. And many surgeons outside of gynecology remain uncertain how it can fit into their practice. Awareness, not evidence, is one of the biggest barriers.
Cancer prevention does not always arrive with fanfare. Sometimes it arrives as a five-minute addition to an operation that was already going to happen.
