Specialists at the Royal College of Obstetricians and Gynaecologists are calling for national guidelines to protect women by removal of the fallopian tubes.
Women who have completed their family should be offered the chance to have their fallopian tubes removed to cut risk of ovarian cancer
The Mail Online reports: the impact could be huge – reducing the risk of the most serious type of ovarian cancer by almost two-thirds for women in their 40s and 50s, it is claimed.
Ovarian cancer affects almost 7,000 women a year, and kills more than 4,000, often because it has spread with few or no obvious symptoms before diagnosis.
Specialists at the Royal College of Obstetricians and Gynaecologists are now calling for national guidelines to protect women by removal of the fallopian tubes, where ovarian cancer starts in more than 70 per cent of cases.
Women at high risk of the disease because they have a BRCA 1 genetic mutation are already advised to have both their fallopian tubes and their ovaries removed as a preventive measure.
But around two-thirds of women who develop ovarian cancer are deemed ‘low risk’ with no family history.
These women become increasingly likely to develop the disease, because it is most common around the age of 60. So removing the fallopian tubes when they have completed their families, probably in their 40s and 50s, could protect the vast majority.
The ovaries would be left intact because their removal would trigger an early menopause but offer no further protection.
Dr Ian Harley, of the Northern Ireland Regional Oncology Centre in Belfast, and lead-author of the paper, said: ‘Being pro-active and if the opportunity arises among women who have completed their families, removal of the fallopian tubes could help reduce the incidence of ovarian cancer.
‘Removal of the fallopian tubes during surgery for other conditions carries minimal additional surgical risk to the patient.’
He said some gynaecologists already suggest this course of action to women who are going to have a hysterectomy, or other gynaecological operations, to be performed at the same time.
In future, women could be offered the chance to have their fallopian tubes removed when they were, for example, having their gall-bladder out. Dr Harley said: ‘Much evidence supports the theory that ovarian high-grade serous carcinomas arise from the fallopian tube and we now know much more about the genetic makeup.
‘There has been little improvement in survival from this cancer, which is the leading cause of death from gynaecological cancers among women in the UK.’
He said more evidence is needed from ongoing trials but results so far suggest the risk of developing ovarian cancer would be cut by at least 60 per cent in women with no family history.
The latest evidence is presented in a new Scientific Impact Paper published today by the RCOG’s scientific advisory committee.
The aim is to use the paper as the basis for new guidelines to be drawn up by the National Institute for Health and Care Excellence (Nice), or the RCOG, to make the practice more accepted, Dr Harley said. It is already being used widely in British Columbia, Canada, he added.
Dr Sadaf Ghaem-Maghami, chairman of the RCOG’s scientific advisory committee, said: ‘Ovarian cancer affects more than 6,500 women in the UK each year and is the fifth most common cancer among women.
‘The identification of the fallopian tube as the origin of high-grade pelvic serous carcinomas has the potential to have significant clinical impact on the reduction of mortality associated with ovarian cancer.’
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