ACOG Expands Salpingectomy Recommendations to Reduce Ovarian Cancer Risk

The American College of Obstetricians & Gynecologists (ACOG) strengthened guidance supporting bilateral salpingectomy to reduce epithelial ovarian cancer risk. In a Clinical Practice Update published August 20 in Obstetrics & Gynecology, ACOG recommended that obstetrician-gynecologists routinely perform bilateral salpingectomy at hysterectomy, with decisions based on informed consent and shared decision making.

ACOG also recommended the procedure for patients who do not desire future fertility and are undergoing nonhysterectomy gynecologic surgery that enters the peritoneal cavity. Complete bilateral salpingectomy is now the preferred tubal procedure for permanent contraception after shared decision making. ACOG also urged obstetrician-gynecologists to support surgical specialists offering salpingectomy during nongynecologic surgery.

A 2016 meta-analysis of 3 studies involving 3,509 patients who underwent salpingectomy and 5,655,702 who did not, found an odds ratio for subsequent ovarian cancer of 0.51 (95% CI, 0.35-0.75). A later meta-analysis reported a similar estimate for bilateral salpingectomy (odds ratio, 0.48; 95% CI, 0.33-0.69). In a 2026 British Columbia cohort, the hazard ratio for serous ovarian cancer was 0.22 (95% CI, 0.05-0.95) among 40,527 patients who underwent salpingectomy during another surgery compared with 45,296 patients who underwent comparator surgery.

Systematic reviews found that short-term ovarian function was not adversely affected, although data are needed on long-term effects, including age at menopause. Adding salpingectomy to an indicated pelvic procedure may increase operative time by 12 to 16 minutes, but the update reported no significant change in operative or perioperative complication risk.

For average-risk patients, ACOG said standalone salpingectomy may be considered through clinician-patient dialogue, but further research on benefits and harms is needed before routine recommendation. Counseling must identify the procedure as permanent contraception, and salpingectomy solely for cancer risk reduction should not be performed during emergency surgery that would not otherwise cause permanent contraception. Surgical plans should remain individualized through shared decision making.

Sources: American College of Obstetricians & Gynecologists. ACOG strengthens recommendations supporting salpingectomy for ovarian cancer prevention. News release. American College of Obstetricians & Gynecologists; August 20, 2026. Accessed August 21, 2026.

American College of Obstetricians & Gynecologists Committee on Clinical Consensus—Gynecology. Salpingectomy for the prevention of epithelial ovarian cancer. Obstet Gynecol. Published online August 20, 2026. doi:10.1097/AOG.0000000000006400