There’s no way to screen for ovarian cancer, and many women don’t get diagnosed until tumors are so advanced that their survival odds are minimal. That’s why doctors have long recommended that women with a high genetic risk for ovarian cancer get their fallopian tubes removed once they’re sure they don’t want to become pregnant.

Now, however, the Ovarian Cancer Research Alliance (OCRA) is recommending that even some lower-risk women consider removing their fallopian tubes.

“If a woman at average risk for the disease is done having children and is already having another pelvic surgery, she should speak with her doctor about having her fallopian tubes removed at the same time,” says Audra Moran, president and chief executive officer of OCRA.

“For women who have a strong family history of breast, ovarian, uterine, or colorectal cancer, or a known genetic mutation, they may want to discuss with their doctor more immediate action,” Moran says. OCRA offers free genetic testing to help women assess their ovarian cancer risk.

Ovarian Cancer Has a Low Survival Rate

Although ovarian cancer is considered rare, it ranks fifth in cancer deaths among women and is the deadliest gynecologic cancer, Moran says. About 20,000 women in the United States are diagnosed with it every year, and about 13,000 women die of it, according to the American Cancer Society (ACS). Less than half of women diagnosed with ovarian cancer survive five years.

Often, ovarian cancer starts in the fallopian tubes, Moran says. This is the case for 70 percent of the most common and most lethal forms of ovarian cancer, she adds.

“Though ovarian cancer is rare, it makes sense to consider removing the tubes, as the tissue that can arise into cancer sits within them,” says Arif Kamal, MD, chief patient officer at the ACS.

What Are the Risk Factors for Ovarian Cancer?

There are several risk factors for ovarian cancer, according to the Centers for Disease Control and Prevention (CDC). These include:

• Being middle-aged or older
• Having a mother, sister, aunt, or grandmother with ovarian cancer
• Having a personal history of breast, uterine, or colorectal cancer
• Having a genetic mutation of BRCA1 or BRCA2, per the CDC
• Having endometriosis
• Having an Eastern European or Ashkenazi Jewish background, per the CDC
• Having difficulty conceiving or never giving birth

Even women with few, if any, of these risk factors may consider removing their fallopian tubes as part of other gynecologic procedures. “Consideration for removal should occur during routine surgeries where largely the uterus or surrounding structures is being surgically manipulated, like during a hysterectomy or procedure to remove uterine fibroids,” says Kamal.

Some women who deliver babies via cesarean section surgeries opt to have their fallopian tubes tied — a procedure known as tubal ligation — at the same time to prevent additional pregnancies. These women may also want to consider completely removing the tubes instead, Moran says.

Tubal Ligation Doesn’t Protect Against Cancer

During tubal ligation, the fallopian tubes are cut, tied, or blocked to permanently prevent pregnancy, but they are otherwise left in place. “While they will no longer allow an egg to pass from the ovaries to the uterus, they can still develop the precursor lesions that can develop into ovarian cancer,” Moran says.

In addition, women getting their tubes tied as a stand-alone procedure might instead consider removing the tubes completely to help lower their risk of ovarian cancer, Kamal says.

Some other ways women can reduce their risk of ovarian cancer include taking hormonal birth control pills for five years or longer, breastfeeding for at least one year, and getting surgery to remove the ovaries or a hysterectomy to remove the uterus, according to the CDC.

While all surgery comes with some risks, the new recommendations for fallopian tube removal as part of other gynecologic procedures carries little if any additional risk, says Stephanie Blank, MD, a gynecologic oncologist at the Icahn School of Medicine at Mount Sinai in New York City.

“If someone is already having surgery, the increased risk with removing the tubes is nominal,” Dr. Blank says. “Because ovarian cancer is usually diagnosed when it has already spread and there are no effective screening tests, in this setting, the potential benefit outweighs the risk even in a relatively rare condition.”