Grant: Project Grant

Ovarian cancer is the 5th most common cause of cancer death in women. There is no reliable screening method for the most common and fatal type of ovarian cancer: high grade serous ovarian cancer (HGSC). We now know that most HGSCs originate in the fallopian tubes rather than the ovaries, which has led to a prevention opportunity: removing the fallopian tubes during other surgical procedures. This has been shown to be safe while also reducing the risk of HGSC by 80%. However, since it is only offered during other surgical opportunities, it is crucial that we offer OBS during as many commonly performed surgeries as possible in order to prevent as many ovarian cancers as possible. Fallopian tube removal needs to be targeted to people who are unlikely to want any future pregnancies. Recent research has shown that the most common surgery in women over the age of 45 where fallopian tubes could have been removed was gallbladder surgery (i.e. laparoscopic cholecystectomy). Many patients who undergo this surgery are in their mid- to late-forties and thus most will no longer be interested in a future pregnancy making this an ideal time to offer fallopian tube removal. However, before expanding practice, we need to ensure that fallopian tube removal during gallbladder surgery is feasible, safe, and cost-effective, which is what we are proposing to do. To participate in this trial, patients across British Columbia and Ontario will be offered fallopian tube removal during their upcoming elective gallbladder surgery. We will study how often both fallopian tubes are successfully removed, surgical process outcomes (such as time in the operating room) and safety outcomes. By expanding fallopian tube removal to gallbladder surgery, we could potentially prevent 20%-50% of the HGSCs in the Canadian population. This would save more lives than any of the therapeutic advancements in ovarian cancer in the past 50 years.