To prevent cancer, more women should consider removing fallopian tubes, experts say

Leading research group even urges women without genetic risk to have their fallopian tubes removed in certain circumstances.

There is no reliable screening test for ovarian cancer. Doctors therefore recommend that women at high genetic risk for contracting the disease have their ovaries and fallopian tubes removed once they have finished having children, usually around the age of 40.

>

On Wednesday, a leading research and advocacy organization expanded on this recommendation in a way that may surprise many women.

Based on evidence that most of these cancers arise from the fallopian tubes, not the ovaries, the Ovarian Cancer Research Alliance urges even women who do not have mutations - that is, say most women - to have their fallopian tubes surgically removed if they are finished having children and are planning a gynecological operation anyway.

In such a procedure, surgeons remove the tubes, which lead from the ovaries to the uterus, but leave the ovaries intact. The ovaries produce beneficial hormones even later in life, reducing the risk of heart disease, osteoporosis and sexual dysfunction. Organ sparing has been associated with lower overall mortality.

"Ovarian cancer is a relatively rare disease, and generally we we're not sending a message to the general population," Audra Moran, president and CEO of O.C.R.A., said. "We want everyone with ovaries to know their level of risk and the steps they can take to help prevent ovarian cancer."

To this end, the group has also started offering free home test kits for eligible women who wish to know if they carry genetic mutations such as BRCA1 and BRCA2, which confer a high risk of developing both cancer ovary and breast.

Young carriers of the mutations might consider removing only the fallopian tubes as an interim measure to protect against ovarian cancer and to avoid sudden early menopause, said Ms. Moran, although the standard treatment for carriers is also to remove the ovaries.

Although women with BRCA1 and BRCA2 mutations are at risk very high incidence of ovarian cancer, the majority of women with the disease do not carry the mutations.

The new advice is a recognition that efforts to developing vital screening tests for the early detection of ovarian cancer have failed, and that women should consider more proactive measures.

A large clinical trial in Britain found that imaging and blood tests for the early detection of ovarian cancer did not detect the cancer early enough to save lives.

< p class="css-at9mc1 evys1bk0">Women were told to heed vague symptoms, like bloating, that might indicate something is wrong, but experts say there is no evidence that vigilance prevents death because symptoms usually occur later in the course of the disease.

The Society of Gynecologic Oncology, an organization of physicians who treat gynecological cancers, has endorsed the new initiative to make genetic testing more accessible and promote prophylactic removal of fallopian tubes in women without genetic risks.

< p class="css-at9mc1 evys1bk0">"It is considered experienced mind," said Dr. Stephanie Blank, president of the company. But "it makes scientific sense and has a lot of appeal".

"Removing the tubes is not as good as removing the tubes and ovaries, but c is better than screening, which doesn't work," she said.

Dr. Bill Dahut, Scientific Director of the American Cancer Society, or A.C.S., said, "There's a lot of good data behind what they're suggesting, showing that for f...