Meta-analysis of changes in epithelial ovarian cancer incidence rates associated with salpingectomy: A comparison of 2022–2023 and earlier periods

This systematic review and meta-analysis evaluated epithelial ovarian cancer (EOC) incidence rates associated with salpingectomy, with an exploratory assessment of temporal trends following guideline-driven increases in opportunistic salpingectomy. A literature search was conducted across PubMed, Web of Science, Cochrane, and Scopus, targeting cohort studies published between January 2015 and September 2023. Eligible studies were cohort studies reporting EOC incidence in women undergoing salpingectomy (opportunistic or risk-reducing) compared to controls without salpingectomy, with sufficient sample sizes (>100 salpingectomy cases) and homogeneous populations. The Newcastle-Ottawa Scale (NOS) was used to assess methodological quality. A meta-analysis calculated the risk ratio (RR) of EOC incidence, with subgroup analysis exploring temporal trends, using a random-effects model. Five cohort studies, involving 5,819,102 women with 31,586 EOC cases, were included, all with low risk-of-bias (NOS scores ≥6). Salpingectomy was associated with a 77.7% reduction in EOC incidence compared to control patients [RR =0.223, 95% confidence interval: (0.182, 0.274), p<0.001; I²=0]%. The 2022-2023 period should be interpreted as a recent evidence window rather than a formally powered comparative period owing to the small number of studies available. These findings confirm that salpingectomy, particularly opportunistic procedures, substantially reduces EOC incidence. Clinicians should consider offering salpingectomy to average-risk women during gynecologic surgeries, with informed consent. Further research with longer follow-up of contemporary cohorts is needed.