Tubal Ligation (Salpingectomy) and Ovarian Cancer Prevention

Will Having Tubal Ligation Surgery Reduce My Risk of Ovarian Cancer?

Caucasian woman exposing her belly
Jason Home/Blend Images/Getty Images

Does tubal ligation surgery (salpingectomy) reduce the risk of ovarian cancer?

History of Tubal Ligation and Ovarian Cancer

For decades, tubal ligation surgeries have been performed to prevent pregnancy in women.  It's an ideal method of birth control for women who are certain they do not want to become pregnant and don't want the inconvenience of taking a daily pill or use another method. The surgery takes about 30 minutes and most women are able to go home the same day of the surgery.

There is a non-surgical method of tubal ligation called Essure, but laparoscopic surgery remains the most common way to ligate the fallopian tubes.

According to numerous studies, tubal ligation surgery, or having your "tubes tied", prevents more than just pregnancy. Years of research shows that tubal ligation may reduce a woman's risk of developing ovarian cancer,   Data review of studies to date suggest that having a tubal ligation may reduce your risk of ovarian cancer, possibly up to 50% in those who have the surgery before age 35.

Type of Ovarian Cancer Affected by Tubal Ligation

Tubal ligation surgery appears to lower the risk of developing a type of ovarian cancer known as ovarian epithelial tumors.  These tumors are the cause of roughly 75% of ovarian cancers, and up to 90% of deaths related to ovarian cancer.

Why Would Tubal Ligation Lower Ovarian Cancer Risk?

Studies show that many types of ovarian originate in the fallopian tube.

By closing off access to to the ovaries from the tubes by ligation, the risk is reduced. The problem with this is that not all ovarian cancers develop in the fallopian tubes. Some develop on the outside of tube and tubal ligation would not provide any protective benefits in cases such as this.

Incidence of Ovarian Cancers

Ovarian cancer is a fairly uncommon type of cancer for women to develop, but unfortunately, is often diagnosed in the later stages of the disease.

  While only 1 to 2 % of women will develop ovarian cancer in their lifetime, it is the 5th leading cause of cancer deaths in women.

Your Risk of Developing Ovarian Cancer

Again, ovarian cancer is uncommon and most women are at low risk of developing it. It is estimated that a woman has a 1 in 71 chance of developing ovarian cancer in her lifetime. 10-15 percent of ovarian cancer cases have a familial/genetic factor; the remaining women do not have any identifiable risk factors or family history of the disease. We do not know the exact causes of ovarian cancer, however, researchers have identified several risk factors.

Risk Factors

  • Obesity -  Obesity appears to increase a woman's risk of ovarian cancer. A study from the American Cancer Society concluded that women who are obese and have ovarian cancer are more at risk of dying of the disease than women who are not obese with ovarian cancer.
  • Estrogen Therapy - Women who have taken estrogen only hormone replacement therapy long term have a higher risk of developing ovarian cancer than women who take estrogen and progesterone hormone replacement therapy.
  • History of Breast Cancer - Women who have had breast cancer may be at a higher risk of developing ovarian cancer, especially if they have a mutated BRCA1 or BRCA2 gene.
  • Age - We also know that as women get older, their risk of ovarian cancer increases.

Preventive Factors

  • Oral contaceptives - Women who take oral contraceptives have a lower risk of developing ovarian cancer, and this reduced risk continues for some time after oral contraceptives are discontinued.  To understand this it is helpful to think of ovulation.  When an egg is released from the ovary into a fallopian tube, an area of inflammation and trauma is created.  It's thought that inflammation such as this may play a role in the development of cancer.  Oral contraceptives (the "pill") inhibits ovulation.
  • Pregnancy and Breastfeeding - Both pregnancy and breastfeeding result in fewer ovulation cycles, as noted above.
  • Hysterectomy and Salpingectomy - Certainly removing the uterus and fallopian tubes lowers the risk of developing uterine cancer.
  • Oophorectomy - Removing the ovaries -- oophorectomy - lower the risk of ovarian cancer, but not completely.  Again, it's thought that some ovarian cancer develop outside of the uterus.

What Happens During a Tubal Ligation Surgery

Tubal ligation is performed under general anesthesia in a hospital or outpatient surgical clinic. It takes about 30 minutes to perform and most women can go home the same day. During the procedure, a small incision is made in the navel and abdomen. The abdomen is inflated using gas to allow the organs to be more visible and provide ample work space. A laparoscope (a lighted instrument with a camera attached) is inserted through an incision and the fallopian tubes are cut, tied, clamped, or sealed. Click here for detailed overview of tubal ligation surgery

Should You Have Tubal Ligation to Reduce Your Risk of Ovarian Cancer?

At the present time, if a woman is not at risk of developing ovarian cancer tubal ligation should not be considered solely for the purpose of reducing her risk of cancer. Since ovarian cancer is not common, the risk reduction would be simply be an added benefit of the surgery.

That said, gynecologists have been encouraged to remove the fallopian tubes during surgeries to remove the uterus (hysterectomy) and during surgeries to remove the ovaries (oophorectomy) as a preventive measure against ovarian cancer.


The American Board of Obstetricians and Oncologists. Committee Opinion. Salpingectomy for Ovarian Cancer Prevention. January 2015. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Salpingectomy-for-Ovarian-Cancer-Prevention

American Cancer Society. Can ovarian cancer be prevented? Updated 03/12/15. http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-prevention

Erickson, B., Conner, M., and C. Landen. The role of the fallopian tube in the origin of ovarian cancer. American Journal of Obstetrics and Gynecology. 2013. 209(5):409-14.

Falconer, H., Yin, L., Gronberg, H., and D. Altman. Ovarian cancer risk after salpingectomy: a nationwide population-based study. Journal of the National Cancer Institute. 2015. 107(2). Pii. dju410.

Gaitskell, K. et al. Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type. International Journal of Cancer. 2016. 138(5):1076-84.

National Cancer Institute. Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets. Ovarian Cancer. Accessed 01/21/16. http://seer.cancer.gov/statfacts/html/ovary.html

Kwon, J. et al. Costs and benefits of opportunistic salpingectomy as an ovarian cancer prevention strategy. Obstetrics and Gynecology. 2015. 125(2):338-45.

Continue Reading