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EP1066 Opportunistic salpingectomy as a risk reducing strategy for high-grade serous carcinoma: a Northern Ireland opinion
  1. HJ Agnew,
  2. AG Brown and
  3. IJG Harley
  1. Gynaecology Department, Belfast City Hospital, Belfast, UK


Introduction/Background Serous tubal intraepithelial carcinoma (STIC) is the precursor of high-grade serous carcinoma (HGSC), and its site of origin is well recognised as the fallopian tube. With the lack of effective screening and often advanced stage at presentation, opportunistic salpingectomy has been proposed as an intervention to decrease the incidence of HGSC in the general population. The logical step would be to introduce this into our routine obstetric and gynaecological surgeries. We assessed the opinions of consultant and trainee obstetrician/gynaecologists in Northern Ireland to this intervention, given that the benefit is currently unknown.

Methodology An anonymous online survey was sent to consultants and trainees to determine their understanding of STIC, barriers to counselling patients and performing opportunistic salpingectomy, in 3 specific scenarios: caesarean section sterilisation, vaginal hysterectomy and sterilisation requests.

Results As stage of training increased so did knowledge regarding STIC. Barriers to counselling included lack of knowledge and evidence, and no accurate risk/benefit ratio. Trainees were more willing to consider opportunistic salpingectomy than consultants; with 90% versus 68% for caesarean section sterilisation, 76% versus 67% for vaginal hysterectomy and 98% versus 77% for sterilisation. Consultant concerns included fertility, lack of evidence and increased complication risk; the latter shared by trainees. The other factor that prevents trainees considering opportunistic salpingectomy is the consultant involved.

Conclusion Overall trainees are much more enthusiastic in their willingness to consider opportunistic salpingectomy. If we can target knowledge gaps, consultant concerns and instigate surgical/procedural teaching for trainees at an early stage of their career, we could improve the uptake of this procedure. This could then potentially have an impact as a risk reducing strategy in those without a defined genetic risk for HGSC.

Acknowledgements: The Ulster Obstetrical&Gynaecological Society, Dr P. Birkett, Dr J. Breen, Dr K. Devlin, Dr R.Farr, Dr A. McNally and Dr A. Wilson, for encouraging responses.

Disclosure Nothing to disclose

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