The number of deaths caused by ovarian cancer in BC could be reduced by 30 percent if gynecologists follow the recommendation of BC Cancer Agency oncologists and remove the fallopian tubes of women undergoing hysterectomies or tubal ligations.

The recommendation is based on a recent discovery by BC researchers at the Ovarian Cancer Research Program (OvCaRe) that most high-grade serous tumours – the deadliest type of ovarian cancer – arise in the fallopian tube rather than the ovary.

Further research revealed 18 percent of women who developed ovarian cancer had previously had a hysterectomy. Since fallopian tubes are not removed as a standard practice during hysterectomies, researchers note this relatively simple change in practice could prevent
ovarian cancer and perhaps death for a significant number of women.

In September, every gynecologist in the province received a DVD explaining the research evidence supporting the recommendation. Dr. Sarah Finlayson, a gynecologic oncologist at Vancouver General Hospital and the BC Cancer Agency, is leading the effort to change the practice of BC’s gynecologists.

“We’re not recommending that women come in off the streets and have their tubes taken out,” says Finlayson. “All we’re saying is that the fallopian tubes should be considered as part of the uterus and should be removed with the uterus for women already undergoing major gynaecological surgery. It’s a very simple surgical change.”

Finlayson says response to the DVD from BC physicians has been excellent, and that BC is likely the first jurisdiction in the world to recommend this practice change for gynecologists.

Ovarian cancer is the fifth leading cause of death for women in Canada. Every year about 310 BC women are diagnosed with ovarian cancer, and each year 220 women in this province die from the disease.

According to Finlayson, the research finding that identified the connection between the fallopian tubes and high-grade serous ovarian cancer generated a “eureka moment” among clinicians in the research group when they realized they could act on the finding.

“We saw that we could actually take that knowledge and translate it into a real change in the way we provide care, and that it could have an immediate impact,” says Finlayson. “It’s very exciting in medicine when that happens.”

Dr. Sarah Finlayson is a gynecologic oncologist at Vancouver General Hospital and the BC Cancer Agency, and an assistant professor in the Faculty of Medicine at the University of British Columbia.