If you’re already going under the knife, having your fallopian tubes removed at the same time could reduce your risk of ovarian cancer, the fifth-deadliest cancer for women.
That’s because most cases of ovarian cancer begin in the fallopian tubes, the hollow passageways connecting the ovaries and uterus—not in the ovaries. By taking these tubes out, you can lower the chance that cancer will develop and spread. In fact, research published earlier this year found that women who had their fallopian tubes removed during another surgery had a 78% lower risk of the most common type of ovarian cancer than those who kept their tubes.
“In my opinion now, if you’re done childbearing, that’s very clear in your mind, and a surgeon is going to be in your abdomen for whatever purpose, whether it be a gynecologic indication or a non-gynecologic, I think with the data that we have now, it’s really a no-brainer to have your fallopian tubes out at the same time, as long as it can be safely performed,” says Larissa A. Meyer, M.D., M.P.H., FACOG, FACS, a professor of gynecologic oncology at MD Anderson Cancer Center.
How are fallopian tubes linked to ovarian cancer?
The idea that ovarian cancer might originate in the fallopian tubes emerged in 2001, when scientists in the Netherlands found precancerous changes inside the fallopian tubes of women with genetic risk factors for ovarian cancer.
You see, the cells lining the fallopian tubes are constantly growing, shedding, and changing. “There are little mutations that can happen in the fallopian tube cells that eventually, through a cascade, one mutation occurs, and then another mutation occurs, and then another mutation occurs, and over time, these cells evolve to develop the cancer,” says Vinita Popat, M.D., a gynecologic oncology fellow at City of Hope.
Over the past 25 years, a growing body of research has strengthened the understanding that many, though not all, ovarian cancers start in the fallopian tubes before infiltrating the abdomen.
When does it make sense to remove fallopian tubes?
The main factor to weigh is your fertility. Since removing your tubes is a permanent form of sterilization, it’s only recommended if you’re sure you do not want to be pregnant in the future.
Aside from that, tube removal is most commonly recommended for women who already know they have an increased risk of ovarian cancer. “In patients who have genetic risk factors or ovarian cancer, like BRCA mutations, we often do risk-reducing surgery,” says Dr. Popat. “We will remove patients’ ovaries and fallopian tubes before they go into menopause.”
That said, women without known genetic risk factors can also benefit from fallopian tube removal because there’s no standard screening test to catch ovarian cancer early. An abdominal CT scan can reveal tumor cells, usually after symptoms develop. “Ovarian cancer is normally diagnosed once it’s reached stage three and spread throughout the entire abdomen,” says Dr. Popat. “People have signs of bloating and abdominal pain, and they may have a mass on their ovaries, but it may just be these general, nonspecific symptoms.”
As the role of the fallopian tubes in ovarian cancer’s origins came into focus, research pointed to a potential solution: removing fallopian tubes during other abdominal or pelvic procedures. All surgeries carry risks of complications, such as bleeding or infections, but adding fallopian tube removal to another surgery—known as opportunistic salpingectomy—doesn’t add much risk. Research suggests that the complication rate for fallopian tube removal is similar to having your tubes tied.
“When you do it at the time of a hysterectomy, or a Cesarean section, or instead of getting your tubes tied, it doesn’t add much time, maybe 10 or 15 minutes max,” says Dr. Meyer. “It can be very fast and safe, and it doesn’t affect things like your ovarian function, so you wouldn’t have to worry about premature menopause or anything like that.”
The procedure has been such a game-changer that many women’s health experts, such as the American College of Obstetricians and Gynecologists, Society of Gynecologic Oncology, European Society of Gynaecological Oncology, and International Federation of Gynecology and Obstetrics, now recommend fallopian tube removal to reduce ovarian cancer risk, and many women are opting in.
In fact, the number of women having their fallopian tubes removed during hysterectomies started rising sharply around 2010. From 2011 to 2022, the rate of women who chose to have their tubes removed rather than tied jumped from 0.1% to 14.6% among postpartum women and from 1.4% to 65.9% in women outside the postpartum period. However, access to the procedure varied across the United States, with many physicians slow to adopt it.
Dr. Meyer and other researchers are studying opportunities to incorporate more fallopian tube removals into nongynecological procedures, such as gallbladder or appendix removal, for women who want them.
Why are we just hearing about this lifesaving procedure now?
For one, it often takes years for new medical breakthroughs to reach health care providers and the public. But financial barriers might have also impeded some progress. Until 2025, medical centers didn’t have a diagnostic code to easily bill insurance for this surgery when it was performed for cancer prevention in people without known genetic risk factors. “We now have a way for it to be recognized as a procedure and reimbursed for normal-risk women,” says Dr. Meyer.
Another barrier: Not all states recognize fallopian tube removal as a form of sterilization covered by Medicaid, which might limit its accessibility for women in certain states. “This is where you see sort of the intersection of what we know medically and the infrastructure that we have to work within in our systems to actually implement this more broadly,” says Dr. Meyer.
Cultural factors also shape whether women want the procedure at all. On one hand, more women than ever are seeking sterilization after the Supreme Court overturned Roe v. Wade. On the other, mistrust in the medical community also keeps some from seeking this care.
“There’s a complicated political milieu in which women’s health is consistently on the map,” says Dr. Meyer. “Historically, there’s some distrust in certain communities about people who were sterilized without their consent or without their knowledge, so I think now when we’re looking at really trying to broadly advocate for women to have their tubes out at the time of another procedure, if they are no longer interested in childbearing, we still have that historical stain.”
What to do next
If you have a family history of ovarian cancer, it’s especially important to talk with your health care provider about strategies to reduce your risk. Your doctor may recommend testing for BRCA1 or BRCA2 mutations, which are associated with an elevated risk of ovarian cancer. If you have either mutation, they might recommend surgery or other preventive measures to reduce your risk of cancer and catch any signs or symptoms of cancer early.
If you don’t have a family history of ovarian cancer, ask your surgeon about fallopian tube removal anytime you’re planning to undergo abdominal or pelvic surgery. Just remember the choice is ultimately yours—your health care provider should share evidence about the risks and benefits without pressuring you one way or the other.
You Might Also Like
