How Salpingectomy During Hysterectomy May Reduce the Risk of Serous Ovarian Cancer

Removing both fallopian tubes during a hysterectomy or another benign pelvic surgery may substantially reduce the risk of high-grade serous Ovarian Cancer, according to a 2026 population-based study published in JAMA Network Open. The study of 85,823 patients found that opportunistic bilateral salpingectomy was associated with about an 80% lower risk of serous ovarian carcinoma compared with comparator surgery.

What Is Opportunistic Salpingectomy?

Opportunistic bilateral salpingectomy, or OBS, involves removing both fallopian tubes during another planned pelvic operation, such as a hysterectomy, while leaving the ovaries in place.

The approach has attracted attention because increasing evidence suggests that many high-grade serous ovarian cancers may originate in the fallopian tubes rather than developing primarily in the ovaries. Removing the tubes during an operation that is already being performed may therefore provide an opportunity for risk reduction without removing the ovaries.

The 2026 study by Ramlogan Sowamber and colleagues evaluated whether this surgical approach was associated with a lower incidence of serous ovarian carcinoma. The findings were published in JAMA Network Open on February 2, 2026. DOI:” target=”_blank”>
https://doi.org/10.1001/jamanetworkopen.2025.57267″>DOI:

10.1001/jamanetworkopen.2025.57267.

Study Included More Than 85,000 Patients

Researchers analysed population-based data involving 85,823 patients who underwent relevant surgical procedures between 2008 and 2020.

Of these:

• 40,527 patients underwent opportunistic bilateral salpingectomy.
• 45,296 patients underwent comparator surgery without opportunistic bilateral salpingectomy.

The median follow-up was 4.72 years in the salpingectomy group and 8.45 years in the comparator group. The patients who underwent comparator surgery were somewhat older at the time of surgery on average, and there were also differences in oral contraceptive use between the groups.

The researchers reported a crude hazard ratio of 0.22 for serous ovarian carcinoma among patients who underwent opportunistic bilateral salpingectomy, with a 95% confidence interval of 0.05 to 0.95. This corresponds to an approximately 78% lower observed hazard in the salpingectomy group. 0

Why the Fallopian Tubes Matter in Ovarian Cancer

High-grade serous carcinoma (HGSC) is the most common histotype of ovarian carcinoma and is responsible for a large proportion of ovarian cancer deaths.

Researchers have increasingly identified the fallopian tube as an important site in the development of many high-grade serous cancers. This has changed the way scientists think about prevention and has led to interest in removing the tubes while preserving the ovaries when women are already undergoing certain gynecologic surgeries.

The study authors note that opportunistic bilateral salpingectomy can target the fallopian tubes while conserving the ovaries. Previous evidence cited in the paper indicates that the procedure is considered safe, does not appear to cause earlier menopause and is cost-effective. 1

High-Grade Serous Cancer Was Less Common After Tube Removal

The researchers also conducted a separate analysis to examine the types of ovarian cancer diagnosed in people who had previously undergone bilateral fallopian tube removal.

Among 26 ovarian carcinomas identified in individuals without fallopian tubes, only 6 cases, or 23.1%, were high-grade serous carcinoma.

That proportion was substantially lower than the 68.1% observed in a historical cohort of 942 ovarian carcinomas among people with intact fallopian tubes, where 642 cases were high-grade serous carcinoma. The difference was statistically significant, with a Fisher exact test P value below .001. 2

These findings support the biological rationale that removing the fallopian tubes may particularly affect the development of high-grade serous disease.

Researchers Used Breast Cancer as a Negative Control

An additional analysis looked at breast cancer as a negative-control outcome. The reported hazard ratio for breast cancer was 0.99, with a 95% confidence interval of 0.84 to 1.17.

The researchers used this analysis to examine whether broader differences between the groups, such as healthcare use or underlying characteristics, might explain the association observed for serous ovarian cancer. The lack of a similar association with breast cancer provided some reassurance, although it does not eliminate all possible sources of confounding in an observational study. 3

Does Salpingectomy Remove the Risk of Ovarian Cancer Completely?

No. Bilateral salpingectomy does not eliminate the possibility of ovarian cancer.

Ovarian carcinoma includes several different histotypes, and removing the fallopian tubes cannot prevent cancers that arise independently of the tubes. The study itself found ovarian carcinomas occurring in people without fallopian tubes, including histotypes other than high-grade serous carcinoma.

Therefore, the findings should be understood as evidence of risk reduction for serous ovarian carcinoma rather than a guarantee against ovarian cancer.

What About the Ovaries and Menopause?

One important feature of opportunistic salpingectomy is that the procedure removes the fallopian tubes while conserving the ovaries.

This distinction matters because the ovaries produce hormones and play an important role in reproductive and endocrine function. The study’s introduction cites previous evidence indicating that opportunistic bilateral salpingectomy does not appear to reduce the age at menopause. 4

However, the decision to remove or retain the ovaries is individual and depends on factors such as age, genetic cancer risk, medical history, the reason for surgery and the patient’s preferences. Salpingectomy should therefore be discussed with a gynaecologist as part of an individual surgical plan.

Why This Matters During Hysterectomy

For a patient already undergoing a hysterectomy for a benign condition, the fallopian tubes may represent an additional target for cancer prevention if bilateral salpingectomy is medically appropriate.

The concept is sometimes described as an opportunity to reduce future cancer risk during a surgery that is already planned, rather than performing a separate operation solely for cancer prevention.

However, whether salpingectomy should be performed depends on the individual clinical situation. Surgical decisions should take into account the reason for hysterectomy, age, ovarian cancer risk, previous surgery, genetic factors and the potential benefits and risks of removing the tubes.

Important Limitations of the Study

Although the findings are significant, the research does not prove that salpingectomy itself caused the reduction in cancer risk.

This was a population-based observational cohort study rather than a randomised clinical trial. The researchers also reported differences between the groups, including age and oral contraceptive use. Although statistical analyses and a negative-control outcome were used to address potential confounding, unmeasured differences between patients can still influence observational results.

The second analysis was also based on only 26 ovarian cancer cases among people without fallopian tubes. The authors noted that the relatively young age of some patients at the time of surgery resulted in limited numbers of cancer events.

Longer follow-up and additional research will therefore be important for understanding the magnitude and durability of the protective association.

What the Findings Mean for Women Considering Hysterectomy

The study adds to growing evidence supporting consideration of opportunistic bilateral salpingectomy during appropriate benign gynecologic surgery.

For women already planning a hysterectomy, a conversation with the treating gynaecologist can include whether removing the fallopian tubes while preserving the ovaries is appropriate in their particular circumstances.

It is important not to interpret the study as recommending salpingectomy for every woman or as a substitute for appropriate cancer-risk assessment. Women with inherited cancer-risk conditions or a strong family history may require a different risk-reduction strategy and specialist counselling.

Conclusion

Opportunistic bilateral salpingectomy could represent an important strategy for reducing the risk of high-grade serous ovarian cancer during selected benign pelvic surgeries. In the 2026 JAMA Network Open study, patients who underwent the procedure had a substantially lower observed hazard of serous ovarian carcinoma, while high-grade serous cancers represented a much smaller proportion of ovarian cancers identified in people without fallopian tubes.

The findings strengthen the evidence behind the concept of targeting the fallopian tubes for prevention while preserving ovarian tissue. At the same time, salpingectomy does not eliminate all ovarian cancer risk, and the decision to undergo the procedure should be individualised after discussion with a qualified gynaecologist.

SEO Details

Primary Keyword: salpingectomy ovarian cancer prevention

Secondary Keywords: opportunistic bilateral salpingectomy, hysterectomy ovarian cancer risk, fallopian tube removal, high-grade serous ovarian cancer, ovarian cancer prevention, salpingectomy during hysterectomy, fallopian tubes and ovarian cancer, ovarian cancer research 2026

Meta Title: Salpingectomy During Hysterectomy May Cut Serous Ovarian Cancer Risk

Meta Description: A 2026 JAMA Network Open study found opportunistic bilateral salpingectomy was associated with a substantially lower risk of serous ovarian cancer.

Reference: Sowamber R, Mei AJ, Kaur P, et al. “Serous Ovarian Cancer Following Opportunistic Bilateral Salpingectomy.” JAMA Network Open. 2026;9(2):e2557267. DOI: 10.1001/jamanetworkopen.2025.57267. 5

Disclaimer: This article is for informational purposes only and does not constitute medical advice. The decision to undergo salpingectomy, hysterectomy or any other gynecologic surgery should be made with a qualified healthcare professional after considering individual medical history, cancer risk and treatment options.