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1030 Opportunistic salpingectomy as primary contraception at the time of caesarean section as a means of ovarian cancer risk reduction: a review of current evidence
  1. Waziri Addo-Yobo,
  2. Emmanouil Katsanevakis and
  3. Ketankumar Gajjar
  1. Nottingham University Hospitals NHS Trust, Nottingham, UK

Abstract

Introduction/Background In females in the UK, ovarian cancer is the 6th most common cancer, with around 7,500 new cases every year. Ovarian cancer accounts for 4% of all new cancer cases in females in the UK with a lifetime risk of 1.4%. About 70% of epithelial ovarian cancers are of the high grade Serous type which are derived from precursors (serous tubal intraepithelial carcinoma) in the fimbriae of the fallopian tubes.

Oncological recommendations in many countries suggest removal of both tubes as a method of primary prevention in post reproductive women undergoing abdomino-pelvic surgery and also as a means of permanent contraception (including at Caesarean Section). This is commonly referred to as ‘opportunistic bilateral salpingectomy’.

Methodology A Comprehensive search was performed on PubMed to review current literature on opportunistic salpingectomy (including at time of Caesarean section), Ovarian Cancer Risk Reduction and permanent contraception.

Results Awareness of salpingectomy reducing the risk of ovarian cancer amongst physicians and the general public has increased over the past few years. Opportunistic salpingectomy is safe, cost effective and has minimal complications.

Major reasons for not performing opportunistic salpingectomy included increased operating time and fear of increased morbidity/complications.

Conclusion Opportunistic salpingectomy decreases the risk of ovarian cancer in the general population and has the potential to be more cost effective in the long term. Operative times for opportunistic bilateral salpingectomy at Caesarean section are minimally increased compared to performing sterilization by bilateral tubal ligation.

Further research should be carried out into long-term survival outcomes and also the current knowledge and attitude of gynaecologists regarding this procedure in the UK and Europe as a whole.

Disclosures None of the authors have any disclosures nor conflicts of interest.

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