Biology never ceases to surprise: preventing cancer of the ovary by tubal ligation

One might have thought that ovarian cancer can be prevented by removing the ovaries – say at the time of hysterectomy – and that obstructing or removing the fallopian tubes would not, by itself, reduce the risk of ovarian cancer. These hypotheses are based on the plausible assumption that cancer arises in the ovaries, just as breast cancer arises in the breast. However, it now appears that ovarian cancer may arise in the fallopian tubes, at least in a substantial proportion of cases. A Swedish record linkage study shows that fallopian tube ligation is associated with a 30% reduction in the incidence of ovarian cancer.[1] Confounding by high fertility do I hear you say? Apparently not as this has been adjusted for. Caused by preventing access of carcinogens ascending the reproductive tract? Probably not, since removal of the fallopian tube provides even stronger protection against ovarian cancer, than does ligation which leaves the ovarian end of the tube in situ. Implausible hypothesis reminiscent of transubstantiation? Apparently not, since cells with the appearance of ovarian cancer have been harvested from fallopian tubes, and the molecular signature of many ovarian cancers suggests a fallopian tube provenance.

— Richard Lilford, CLAHRC WM Director

Reference:

  1. Falconer H, Yin L, Grönberg H, Altman D. Ovarian cancer risk after salpingectomy: a nationwide population-based study. J Natl Cancer Inst. 2015; 107(2): dju410.
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