Interventions to reduce the risk of ovarian and fallopian tube cancer: A European Menopause and Andropause Society Postition Statement

Abstract

Background: Ovarian cancer is a leading cause of female gynecological cancer-related death, and there are no effective screening procedures or early diagnostic approaches.

Aims: To examine risk factors and risk-reducing strategies for both sporadic and familial tumors.

Materials and methods: Literature review and consensus of expert opinion.

Results and conclusions: In women with a genetic predisposition to ovarian cancer, salpingo-oophorectomy reduces the risk of ovarian malignancy, and to a lesser degree of breast cancer. Opportunistic bilateral salpingo-oophorectomy and bilateral salpingectomy may also prevent epithelial ovarian cancer. In premenopausal women, bilateral salpingectomy should be preferred to tubal ligation, and be performed when hysterectomy is carried out for benign uterine disease. Hysterectomy and the use of combined oral contraceptives and non-steroid anti-inflammatory drugs are also recognized to reduce the risk of ovarian cancer, as do the prevention of obesity and smoking cessation.

Keywords: BRCA gene mutation; Bilateral oophorectomy; Bilateral salpingectomy; Combined oral contraceptives; Fallopian tubes cancer; Hysterectomy; Non-steroid anti-inflammatory drugs; Obesity; Ovarian borderline tumors; Ovarian cancer; Smoking.