Salpingectomy for ectopic pregnancy reduces ovarian cancer risk-a nationwide study

JNCI Cancer Spectr. 2024 Apr 30;8(3):pkae027. doi: 10.1093/jncics/pkae027.

Abstract

Recent studies propose fallopian tubes as the tissue origin for many ovarian epithelial cancers. To further support this paradigm, we assessed whether salpingectomy for treating ectopic pregnancy had a protective effect using the Taiwan Longitudinal National Health Research Database. We identified 316 882 women with surgical treatment for ectopic pregnancy and 3 168 820 age- and index-date-matched controls from 2000 to 2016. In a nested cohort, 91.5% of cases underwent unilateral salpingectomy, suggesting that most surgically managed patients have salpingectomy. Over a follow-up period of 17 years, the ovarian carcinoma incidence was 0.0069 (95% confidence interval [CI] = 0.0060 to 0.0079) and 0.0089 (95% CI = 0.0086 to 0.0092) in the ectopic pregnancy and the control groups, respectively (P < .001). After adjusting the events to per 100 person-years, the hazard ratio (HR) in the ectopic pregnancy group was 0.70 (95% CI = 0.61 to 0.80). The risk reduction occurred only in epithelial ovarian cancer (HR = 0.73, 95% CI = 0.63 to 0.86) and not in non-epithelial subtypes. These findings show a decrease in ovarian carcinoma incidence after salpingectomy for treating ectopic pregnancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Ovarian Epithelial* / epidemiology
  • Carcinoma, Ovarian Epithelial* / surgery
  • Case-Control Studies
  • Female
  • Humans
  • Incidence
  • Middle Aged
  • Ovarian Neoplasms* / epidemiology
  • Ovarian Neoplasms* / prevention & control
  • Ovarian Neoplasms* / surgery
  • Pregnancy
  • Pregnancy, Ectopic* / epidemiology
  • Proportional Hazards Models
  • Salpingectomy*
  • Taiwan / epidemiology
  • Young Adult