A considerable proportion of patients with high-grade serous cancer (HGSC) have missed opportunities for risk assessment with genetic testing and for surgical prevention, according to a study published online August 13 in JAMA Surgery.
Sara Moufarrij, M.D., from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues examined the frequency of missed opportunity for salpingectomy with/without oophorectomy among patients diagnosed with HGSC in a retrospective study conducted between 2015 and 2021 (1,877 patients). Missed opportunity was defined as a history of sterilization procedures at any age or abdomino-pelvic surgeries at age 45 years or older when salpingectomy could have been performed one year or longer before a diagnosis of HGSC. In addition, an electronic survey was administered to members of a national ovarian cancer organization who self-identified as having had an HGSC diagnosis; 348 of the 917 respondents were diagnosed with HGSC.
The researchers found that of the 445 patients with missed opportunities for salpingectomy in the retrospective cohort, 54.2% and 45.8% had a tubal ligation/hysterectomy and had other abdomino-pelvic surgeries, respectively. Compared with younger patients, cholecystectomy, hernia repair, and bowel surgeries were more commonly performed for patients aged 45 years or older. Missed opportunity was reported by 15.5% of the 348 survey respondents. Among patients with an affected first-degree relative in the retrospective cohort, there was a 43.2% missed opportunity rate for germline genetic testing and reflex risk-reducing surgery.
“As we deepen our understanding of the pathogenesis and risk factors for cancers arising directly or indirectly from the fallopian tube, the future of ovarian cancer prevention is poised to evolve toward targeted salpingectomy based on polygenic risk modeling and individualized risk stratification,” the authors write.
Several authors disclosed ties to the biopharmaceutical and publishing industries.
More information:
Sara Moufarrij et al, Gauging the Magnitude of Missed Opportunity for Ovarian Cancer Prevention, JAMA Surgery (2025). DOI: 10.1001/jamasurg.2025.2810
Lauren Gilgannon et al, Opportunistic Salpingectomy, JAMA Surgery (2025). DOI: 10.1001/jamasurg.2025.2818
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Missed opportunity common in patients with high-grade serous ovarian cancer (2025, August 15)
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