It’s a disease so hard to spot in early stages that doctors have long dubbed it the ‘silent killer’.
But experts say they may have found an effective but extreme way to slash a woman’s risk of ovarian cancer by as much as 80 per cent: removing her fallopian tubes.
Ovarian cancer strikes more than 7,000 British women each year, with one in 50 developing it during their lifetimes.
The condition causes few symptoms until it has already spread to surrounding organs, and there is no reliable way to screen for it. As a result, nearly four in five cancers are caught at a late stage, when they are no longer curable. It’s a devastating diagnosis – and for around 4,000 Britons each year, a deadly one.
But growing research over the past 20 years has shown that nearly all ovarian cancers – and certainly the vast majority of the deadliest ones – originate in the fallopian tubes.
These tubular ducts, responsible for carrying eggs from the ovaries to the uterus, are just 10cm long, on average. Removing them, studies show, can significantly slash the risk of deadly cancer.
The procedure is already being offered to women in the UK at high risk of the disease, as part of a large-scale national research trial. But experts now say that even women with no genetic risk of ovarian cancer could benefit from having their fallopian tubes removed.
In fact, a number of health bodies across the UK and US are encouraging doctors to offer tube removal to all women over 45 – when they are unlikely to still want children – who are already undergoing abdominal surgery.
Called an opportunistic salpingectomy, the procedure adds just five minutes – and few extra risks – to an existing surgery.
It also doesn’t carry the same long-term issues as removing the ovaries, which sends women into premature menopause, raising their risk of heart disease, osteoporosis and even dementia.
EastEnders star Kara Tointon, 43, was pregnant with her first child when she tested positive for the BRCA1 gene mutation in 2018
It may sound extreme – particularly as 98 per cent of women won’t go on to develop ovarian cancer – but preliminary research suggests that the operation could prevent thousands of deadly ovarian cancers if offered to all eligible women.
‘We know that around one in five cases of the most serious type of ovarian cancer will be related to a gene mutation or family history,’ says Dr Richard Edmondson, clinical professor in gynaecological oncology at the University of Manchester. ‘But that’s only 20 per cent. A wider strategy is needed to prevent that remaining 80 per cent of women deemed at average or low risk of ovarian cancer. Opportunistic salpingectomy is an important step in that process.
‘Plenty of women undergo various forms of abdominal surgery. If we can reduce their risk of ovarian cancer by 80 per cent, that’s major progress. Any woman who is undergoing surgery where this procedure can be carried out easily and without additional risk should be offered it.’
Ovarian cancer has long been considered one of the trickiest cancers to catch early, when it is still curable.
Symptoms tend to develop only once the cancer has spread to other organs and can be maddeningly vague – ranging from abdominal bloating, to fatigue, to a decrease in appetite. As a result, patients are left with few options beyond chemotherapy, which eventually stops working.
Today, just 17 per cent of women with stage four ovarian cancer will live for five years or more. Research shows screening is also virtually useless – a major British trial published in 2023 found neither imaging scans nor blood tests spotted the cancer early enough to save lives.
But groundbreaking findings on the early development of the disease mean experts now believe they can prevent it entirely.
Dutch researchers first posited the theory that ovarian cancer actually begins in the tubes, not the ovaries, after noticing that precancerous cells were rarely found in the ovaries, but often in the fallopian tubes. But they were met with near-universal scepticism.
However, pioneering studies over the past 20 years soon proved them right. Major research trials found that, rather than developing in the ovaries themselves, cancers were instead beginning in the end of the fallopian tube.
These microscopic cells would float out and take root in an ovary – yet failed to show up on ultrasound or other imaging.
Studies found that by removing the fallopian tubes before these cancerous cells had a chance to develop in the ovaries, doctors could cut the risk of ovarian cancer by as much as 80 per cent in high-risk women.
The remaining 20 per cent of cancers that did begin in the ovaries, meanwhile, tended to be the less lethal variants, and were largely curable.
Today, the gold-standard preventative surgery for women who are considered high risk for ovarian cancer – whether due to a strong family history of the disease, or a genetic predisposition such as the BRCA1 or BRCA2 mutations – is still the removal of the ovaries and fallopian tubes.
But while reducing the risk of ovarian cancer by up to 95 per cent, the operation can come with long-term complications, particularly for premenopausal women, who are sent into early menopause.
![¿By removing [fallopian tubes] and keeping an eye on things you could keep your ovaries for longer,¿ said Kara in an Instagram video](https://i.dailymail.com/1s/2026/08/15/17/110657503-16055081-image-a-43_1786810326119.jpg)
‘By removing [fallopian tubes] and keeping an eye on things you could keep your ovaries for longer,’ said Kara in an Instagram video
While hormone-replacement therapy can be used to reduce symptoms of sudden menopause, the extended loss of protective hormone oestrogen has been linked to higher blood pressure and cholesterol, a higher chance of memory loss and dementia later in life, and even higher all-cause mortality.
A British research project has been investigating, for the past eight years, how effective removing the fallopian tubes could be at preventing ovarian cancer.
Called the PROTECTOR trial, the study offers fallopian tube removal to women who are at an increased risk of ovarian cancer but have not yet gone through menopause. Once they become menopausal, they can then have their ovaries removed – further reducing their risk of cancer.
The official results won’t be published for the next ten years or so – meaning health service guidance still recommends that women at high-risk for ovarian cancer have both their ovaries and tubes removed.
But for many women facing a life-changing diagnosis, preliminary evidence is enough to make fallopian tube removal an appealing option.
EastEnders star Kara Tointon, 43, was pregnant with her first child when she tested positive for the BRCA1 gene mutation in 2018. She wanted more children, so waited until the birth of her second son to decide what to do.
‘It was my surgeon who recommended the PROTECTOR trial to me,’ she says. ‘He gave me the option of removing my ovaries and starting on HRT. Then he mentioned that there was growing research to suggest that ovarian cancer was beginning in the fallopian tubes, and that by removing them and keeping an eye on things you could keep your ovaries for longer.’
Kara decided to take part in the trial, after discussing the options at length with her family.
‘At the time, losing my ovaries felt quite daunting,’ she says.
She had the procedure done in 2024, adding: ‘The surgery itself was so straightforward.
‘I arrived in the morning and left that afternoon. I just have regular blood tests to look out for things at the moment.’
A growing number of experts now say the procedure should also be routinely offered to women at average risk of the disease, who are already undergoing an abdominal surgery.
‘We’ve already established that removing a high-risk woman’s fallopian tubes prevents the deadliest ovarian cancers,’ says Prof Edmondson.
‘And research suggests the same is true for women at average or low risk of cancer. It seems a no-brainer, really.’
Only women who no longer want – or can no longer have – children would be eligible for the procedure, and would need to be properly counselled, say experts. But the five-minute operation can be done as part of nearly any abdominal surgery – including gallbladder surgeries, hernia repairs and even caesareans.
Growing research over the past 20 years has shown that nearly all ovarian cancers – and certainly the vast majority of the deadliest ones – originate in the fallopian tubes
And experts say it carries very few additional risks for patients already undergoing surgery.
Rare issues that can arise include bleeding at the removal site, the standard risk of infection and accidental injury to nearby organs, including the ovaries. It also won’t prevent all forms of cancer – particularly the one in five tumours that do stem from the ovaries.
‘When you remove more tissue, there can be a higher chance of bleeding or damage to other organs,’ says Professor Adam Rosenthal, consultant gynaecologist at University College London Hospitals.
‘We also don’t know enough yet about whether having the fallopian tubes removed can trigger earlier menopause in some women. But it’s usually a very simple operation. As long as a woman has adequate information to help her decide whether it’s the right thing to do for her, and no other medical problems that would make the surgery more dangerous, then it’s usually a very easy thing to do that will statistically reduce her risk of ovarian cancer.’
Other experts, however, warn that doing the procedure on average-risk women could have long-term consequences.
‘Even if you properly counsel patients, there’s always the risk that if their tubes are removed, women may think they can never get ovarian cancer, which isn’t true,’ says Dr Elaine Leung, clinical lecturer in gynaecological oncology at the University of Birmingham.
‘As a result, they might be more likely to dismiss symptoms of the condition in the future, and delay treatment.’
The procedure is already being offered to women in the UK. The British Gynaecological Cancer Society updated its guidance in 2024 to recommend opportunistic salpingectomy be considered at the time of routine abdominal surgery for average-risk women who have finished having children.
And top international bodies – including the International Federation of Gynaecology and Obstetrics and the European Society of Gynaecological Oncology – have followed suit in backing the surgery. But some experts say still not enough women are being given the option by medics.
Professor Ranjit Manchanda, consultant gynaecological oncologist at Queen Mary University of London, has spent the past 20 years working on ovarian cancer prevention, and runs the PROTECTOR trial that treated Kara.
One reason why fallopian tube removal is not more broadly offered, he says, is because few women know about it.
‘But it’s also a training issue,’ he adds. ‘While many gynaecological surgeons will easily be able to do the procedure, doctors in other specialties may not.’
In the long-term, fallopian tube removal is only one piece of the puzzle, says Prof Manchanda.
‘This is a huge and important finding. But we know that the number of cancer cases are only rising.
‘At the moment, surgical intervention is the best way we know of to prevent ovarian cancer.
‘But in the future we need to find better ways to identify women who are at high risk of the disease – and offer them more personalised care and prevention strategies.’
