STAT+: To prevent ovarian cancers, fallopian tube removal is on the rise
To prevent ovarian cancers, fallopian tube removal is on an upsurge — and diagnostic manuals are finally catching up.
To Rebecca Stone, the single most important fact about ovarian cancer is that it’s usually a misnomer. The most common kind — responsible for 70% of cases and 90% of deaths — often has its silent beginnings not in the ovary, but in the fallopian tube. This isn’t just an interesting factoid; as a gynecologic oncologist at Johns Hopkins, Stone sees it as a reason to evangelize. There’s no way to screen for so-called ovarian cancer, no colonoscopy, mammogram, or Pap smear equivalent. It’s typically found late, once it’s already spread. The treatments are middling at best. Among the best tools is surgical prevention: If someone doesn’t want more kids, and is considering another abdominal surgery, a surgeon can offer to take the tubes out.
Opportunistic salpingectomy, it’s called. “Somebody says, ‘Can I get my tubes tied?’ And I will say, ‘Well, actually, we don’t tie tubes anymore, we remove them,’” said Greg Marchand, an OB-GYN in Mesa, Ariz. There are exceptions, but generally, since the American College of Obstetricians and Gynecologists recommended offering it in 2015, he’s gone with salpingectomy.
Yet if Stone feels the need to proselytize about it, it’s because she often meets doctors who don’t know about it. She remembers her surprise when she clicked into a virtual meeting in 2023 with medical bureaucrats whose jobs involve tracking diagnoses and interventions. “There were hundreds of people on this call, lots of them medical coders — people who are familiar with the development of new coding for new discoveries — and they had never heard of this. No one,” Stone said.
