Medical screenings are crucial for the prevention or early detection of cancers. From mammograms to Pap smears to HPV tests and colonoscopies, regular screenings can help detect signs of cancer early for those identified female at birth.
But for ovarian cancer — the fifth-deadliest cancer among women — there is no effective screening at this time.
According to the National Cancer Institute, there were nearly 21,000 cases of ovarian cancer diagnosed in the U.S. in 2025 and about 12,700 deaths attributed to the disease.
“Identifying a reliable means to detect ovarian cancer early continues to be an important focus for investigators globally,” said UCLA Health gynecologic oncologist Beth Karlan, MD. “But there is something women can do today to significantly reduce their risk of the most common and most deadly kind of ovarian cancer.”
Most ovarian cancer does not actually begin in the ovaries, but rather in the lining of the fallopian tubes. The cancerous cells shed from the ends of the tubes onto the ovaries where they can further grow and spread. Studies show that removal of both fallopian tubes reduces the risk of ovarian cancer by nearly 80%.
One preventive measure to avoid getting ovarian cancer, endorsed by experts globally, is for women who no longer plan to have children to consider salpingectomy, or removal of the fallopian tubes.
In August, the American College of Obstetricians and Gynecologists updated its guidance regarding salpingectomy, strongly recommending doctors discuss the procedure with patients who are no longer planning to have children as an option during gynecologic and non-gynecologic procedures in the abdomen or pelvis.
“More than two-thirds of women who are diagnosed with ovarian cancer already have metastatic advanced-stage disease,” said Dr. Karlan, a member of the UCLA Health Jonsson Comprehensive Cancer Center. “There are novel screening tests in clinical development, but none that are ready for prime time. The Holy Grail is not just finding ovarian cancer before it causes symptoms, but rather, finding it before it spreads and is still at a curable stage.”
Dr. Karlan discussed the benefits of the procedure as part of a broader look at ovarian cancer risk and prevention.
Why opt for a salpingectomy?
“We’ve discovered that the most common and deadly type of ovarian cancer actually begins in the distal end of the fallopian tubes. Those cells at the end of the fallopian tubes undergo molecular damage and can become malignant,” said Dr. Karlan.
Removal of the fallopian tubes – along with the ovaries – has been standard care for those at high risk of ovarian cancer. But the benefits of removing the fallopian tubes, alone, for those at average risk have become increasingly clear as well.
“It’s a conversation all women should have if they’ve completed childbearing and plan to undergo abdominal surgery,” said Dr. Karlan. “The most important thing is that any woman who is having a hysterectomy or planning a surgical sterilization procedure should discuss removal of her fallopian tubes with her gynecologist.”
People having a non-gynecologic abdominal surgery who are done having children also should have that discussion, Dr. Karlan said. Salpingectomy to prevent ovarian cancer is often referred to as an “opportunistic” salpingectomy, because doctors who will be in the area of the fallopian tubes for another procedure have an opportunity to remove the tubes at the same time.
“There is now something women can do to reduce their ovarian cancer risk and take action to prevent this serious disease,” she said.
Is the procedure safe?
Safety studies have shown no additional surgical complications, blood loss or hospitalization stays. And, perhaps most importantly, removing the fallopian tubes does not impact ovarian function so it does not cause premature menopause, Dr. Karlan said.
How common is the procedure?
Dr. Karlan will be co-chairing a National Cancer Policy Forum workshop later this year that will explore strategies to establish a national standard of care for ovarian cancer prevention through bilateral salpingectomy. She stressed the importance of educating patients, doctors and other healthcare providers about the procedure’s potential to save women’s lives. Though the origin of ovarian cancer in the fallopian tubes is recognized among gynecological surgeons, there isn’t a broad understanding about this biology across other fields, she said.
“According to a recent survey, 80% of general surgeons were not aware that ovarian cancer begins in the fallopian tubes, not the ovaries,” Dr. Karlan said. “I think we need strategies to educate women directly and empower them to discuss risk reduction with their doctors. But to increase salpingectomy uptake, we also need to ensure that their doctors have heard of preventive salpingectomy.”
A thoughtful strategy to communicate the value of salpingectomy to prevent death from ovarian cancer is especially important in light of its resulting sterilization and the climate of increased public mistrust of health care, she said.
“When someone comes to see me as a gynecologic oncologist, they’re already concerned about cancer risk, and I haven’t seen much mistrust in my own practice,” Dr. Karlan said. But, she added, she is very aware of history and understands how a patient might respond negatively to “being told to remove healthy reproductive organs.”
As part of the education process, she said, UCLA Health OB/GYN residents are being trained to routinely consider removing the fallopian tubes when doing a hysterectomy and certain other procedures.
“When they are doing a Cesarean section and the patient desires permanent sterilization, we recommend removing the tubes rather than just tying them,” she said.
Can ovarian cancer be detected early?
Only 25% of ovarian cancers are detected at an early stage. This is due to the lack of reliable screening, as well as symptoms that tend to be non-specific and easily ignored. Those symptoms may include bloating; changes in bowel or bladder habits, such as increased urination; early satiety (feeling full quickly); and pelvic pressure and pain.
“If you develop these symptoms, there are diagnostic tests that can help pinpoint the cause, such as transvaginal ultrasound and the CA-125 blood test,” Dr. Karlan said.
But these tests don’t reliably detect ovarian cancer at an early stage, she said. And even if they detect cancer a few weeks earlier, studies show it doesn’t necessarily reduce the mortality rate.
When caught early, ovarian cancer is 90% curable, Dr. Karlan said. That drops to 30% in later stages.
“Listen to your body. Do not ignore symptoms that are persistent and progressive,” she said. “Even if it’s only been two weeks, it’s worth calling your doctor.”
What are the risk factors for ovarian cancer?
The most important risk factor for ovarian cancer is family history or heredity. Mutations in certain genes significantly increase the cancer risk, such as BRCA1 and BRCA2, or genes associated with Lynch syndrome, a hereditary condition that commonly increases the risk of colon, uterine and ovarian cancer. Women with a BRCA1 mutation have a 35% to 70% lifetime risk of ovarian cancer. The risk with a BRCA2 mutation is 10% to 30%.
“You should find out the health history on both sides of your family,” Dr. Karlan says. “Family cancer history is the greatest risk factor, and you’re just as likely to inherit a gene associated with ovarian cancer from your father as your mother.”
Other risk factors include:
- Age, with the highest rates of ovarian cancer in women ages 55 to 64
- Being overweight or obese increases the risk of developing any cancer
- Endometriosis, a condition in which the uterine lining grows outside the uterus
- Ancestry, such as Ashkenazi Jewish background
- Personal or family history of cancer, specifically breast, uterine, colorectal or pancreatic cancer
- Reproductive history, particularly never having children or having them later in life.
Other ways of reducing ovulation to reduce risk
Preventing regular ovulation reduces the risk of ovarian cancer. Each time the body ovulates, the process of releasing the egg can damage the cells within the fallopian tubes.
There are two ways to reduce ovulation:
- Take birth control pills: Birth control pill use for at least five cumulative years before menopause can reduce ovarian cancer risk by almost 50%, Dr. Karlan said. And the risk reduction continues even after birth control pills are stopped.
- Have children and breastfeed: The more time the body spends in a state of pregnancy and lactation, the less time it is ovulating. People who give birth have a 30% to 40% lower risk of ovarian cancer than those who have never been pregnant. And each pregnancy provides some additional risk reduction.
