Grant: Project Grant

Ovarian cancer is the leading cause of death due to gynecological malignancies. We now know that most ovarian cancers begin in the fallopian tube rather than the ovary. Herein we assess the effectiveness of fallopian tube removal at the time of hysterectomy or instead of tubal ligation for those seeking permanent sterilization as an ovarian cancer prevention strategy. We will capitalize on the remarkable success of an educational program in the Canadian province of British Columbia that recommended fallopian tube removal in women have these surgeries. Previous analysis of the major perioperative safety concerns of performing fallopian tube removal was reassuring, but we have no long-term data on the hormonal implications of fallopian tube removal. We propose to use the large population-based health care datasets available in British Columbia and Ontario to study all women who have had fallopian tube removal at the time of other pelvic surgery between 1985 and 2018. We will compare these women with women who underwent the same types of pelvic surgery but kept their fallopian tubes. We aim to: 1.Determine whether fallopian tube removal is an effective ovarian cancer prevention strategy. To understand whether fallopian tube removal is achieving the impact we hope without burdening the health care system, we need to understand the costs of performing the procedure as compared to the surgery that the women would have undergone before fallopian tube removal became recommended practice and whether additional costs are offset by prevented ovarian cancers. Our research will seek to understand whether the extra costs of performing fallopian tube removal may be entirely offset by the cost savings that would result from a decreased future incidence of ovarian cancer by: 2.Providing detailed analyses of the cost implications in Canada.