Grant: Operating Grant: CCS/CIHR Action Grants

Need for project Ovarian cancer continues to be a leading cause of cancer related death. In 2020, there were 3100 Canadians diagnosed with ovarian cancer, and 1950 Canadians who died of ovarian cancer, making it the 5th ranking cause of cancer-related mortality in women. We have no effective screening method, and treatment has not meaningfully changed survival rates in the past 30 years. However, removal of fallopian tubes can prevent this deadly disease. Goal of project Opportunistic salpingectomy (OS), the removal of fallopian tubes during hysterectomy and instead of tubal ligation, has been recommended practice since 2015 in Canada. However, the rates of hysterectomies and tubal sterilizations have been steadily declining over time. To prevent as many ovarian cancers as possible, we aim to understand whether OS can feasibly, safely, and cost-effectively provided during colorectal surgery by launching and studying a pilot project with colorectal surgeons. Project description We will run a pilot program with colorectal surgeons in Vancouver, BC offering OS to people with fallopian tubes who are finished childbearing and are undergoing an intra-abdominal procedure for benign or malignant colorectal disease. We will determine the proportion of patients who successfully had both fallopian tubes removed during their colorectal surgery and compare rates of complications between those undergoing OS and controls. We will also assess the cost-effectiveness of OS. Future impact OS is feasible, safe, and cost-effective at the time of gynecologic surgery (hysterectomy and tubal sterilization). Preliminary data from British Columbia (BC) also indicate that it effectively prevents ovarian cancer. There has not been a single case of high-grade serous carcinoma (the most common and deadliest form of ovarian cancer) following OS in BC, significantly fewer than expected based on rates in the control group. To save the largest possible number of lives, we need to expand our reach beyond those undergoing hysterectomy or tubal ligation. This project determines whether such an expansion is feasible, safe and cost-effective.