Salpingectomy for ectopic pregnancy reduces ovarian cancer risk - a nationwide study

Recent studies propose fallopian tubes as the tissue origin for many ovarian epithelial cancers. To further support this paradigm, we assessed whether salpingectomy for treating ectopic pregnancy had a protective effect using the Taiwan Longitudinal National Health Research Database. We identified 316 882 women with surgical treatment for ectopic pregnancy and 3 168 820 age- and index-datematched controls from 2000 to 2016. In a nested cohort, 91.5% of cases underwent unilateral salpingectomy, suggesting that most surgically managed patients have salpingectomy. Over a follow-up period of 17 years, the ovarian carcinoma incidence was 0.0069 (95% confidence interval [CI] ¼ 0.0060 to 0.0079) and 0.0089 (95% CI ¼ 0.0086 to 0.0092) in the ectopic pregnancy and the control groups, respectively (P< .001). After adjusting the events to per 100 person-years, the hazard ratio (HR) in the ectopic pregnancy group was 0.70 (95% CI ¼ 0.61 to 0.80). The risk reduction occurred only in epithelial ovarian cancer (HR ¼ 0.73, 95% CI ¼ 0.63 to 0.86) and not in non-epithelial subtypes. These findings show a decrease in ovarian carcinoma incidence after salpingectomy for treating ectopic pregnancy.