High-Grade Serous Ovarian Cancer Patients Often Miss Key Preventive Opportunities

A significant number of individuals diagnosed with high-grade serous ovarian cancer (HGSC) are failing to take advantage of critical opportunities for risk assessment through genetic testing and preventative surgical measures, as highlighted in a recent study published in JAMA Surgery.

Researchers at the Memorial Sloan Kettering Cancer Center conducted a retrospective analysis involving 1,877 patients diagnosed with HGSC between 2015 and 2021. The study focused on the frequency of missed opportunities for salpingectomy, a surgical procedure that removes the fallopian tubes, with or without oophorectomy, the removal of one or both ovaries.

A missed opportunity was defined as having undergone sterilization procedures or abdominal or pelvic surgeries at age 45 or older when salpingectomy could have been performed at least one year prior to the diagnosis of HGSC. Additionally, an electronic survey was conducted with members of a national ovarian cancer organization, where 348 out of 917 respondents reported having been diagnosed with HGSC.

Findings revealed that among the 445 patients identified with missed opportunities for salpingectomy, 54.2% had undergone tubal ligation or hysterectomy, while 45.8% had other abdominal or pelvic surgeries. Notably, older patients were more likely to have undergone surgeries such as cholecystectomy, hernia repair, and bowel surgeries compared to younger individuals. From the survey, 15.5% of respondents indicated they had missed opportunities for preventative measures. Furthermore, for patients with a first-degree relative affected by ovarian cancer in the retrospective cohort, the missed opportunity rate for genetic testing and related surgeries was found to be 43.2%.

The authors of the study emphasize that as understanding of the origins and risk factors for cancers linked to the fallopian tubes improves, approaches to ovarian cancer prevention may increasingly focus on targeted salpingectomies guided by polygenic risk assessments and individualized risk stratification.

This study underscores the need for improved awareness and education regarding the potential benefits of preventive surgical interventions and genetic testing among patients predisposed to high-grade serous ovarian cancer.