Does Ovarian Cancer Actually Originate in the Fallopian Tubes?

Ovarian cancer is known as the silent killer. Screening is ineffective for ovarian cancer, and most diagnoses are made in patients where the disease is already advanced. That’s why new data about an old theory has become such a hot topic. 

“It has always been difficult for researchers to figure out how ovarian cancer comes about, because we often didn’t see any precancerous lesions in the ovary,” says Mitchell Edelson, MD, Enterprise Lead for Gynecologic Oncology with Sidney Kimmel Comprehensive Cancer Center. “Then researchers started to notice precancerous lesions in the fallopian tubes of women at high risk for ovarian cancer. We came to understand that some ovarian cancers develop in the tubes and then overrun the ovaries. That’s why we called it ovarian cancer.” 

The theory that the most common (and most deadly) ovarian cancer type originates in the fallopian tubes – and not the ovaries – has been under study for a while. It follows that an elective salpingectomy (removal of the fallopian tubes) can greatly reduce the risk for developing ovarian cancer. 

The surgery, which takes about three minutes, can be done at the same time a woman is undergoing some other abdominal surgery, such as a hysterectomy, gallbladder removal, or a cesarean section. This path was recently supported by the American College of Obstetricians and Gynecologists in a Clinical Practice Update for October 2026. In essence, it says:

“Obstetrician–gynecologists should routinely perform a salpingectomy at the time of hysterectomy … and should also recommend the procedure to patients (who do not desire future fertility) who are undergoing other types of gynecologic surgery.”

“Recent studies looked at data of women who had their fallopian tubes removed, and found they were 65% less likely to get ovarian cancer,” says gynecologic oncologist M. Bijoy Thomas, MD, Chief, Division of Gynecologic Oncology with Lehigh Valley Topper Cancer Institute, part of Sidney Kimmel Comprehensive Cancer Center. “Removing the fallopian tubes does not eliminate the risk but can greatly reduce it.” 

At the Cancer Institute, if a woman is of average risk, past her childbearing years or not interested in having children, and is undergoing an unrelated pelvic procedure, the clinical team will discuss a salpingectomy with the patient. 

“It only takes a few minutes beyond the primary procedure, and it doesn’t increase complications,” Dr. Thomas says, adding the surgery usually involves counseling because of its permanent nature. “Removing the fallopian tubes is not like tying them, which was done years ago. There is no reversing the process.”   

A salpingectomy alone is not recommended for women at high risk for ovarian cancer, such as those with a genetic mutation in the BRCA1 gene. The standard recommendation for these women is to have both the ovaries and fallopian tubes removed starting as early as age 35 for prevention. 

Drs. Thomas and Edelson both note that these women are usually concerned about the side effects of early menopause associated with removal of the ovaries. This triggers an important question: Is removal of the fallopian tubes versus removal of both the ovaries and fallopian tubes equally effective in preventing cancer in these high-risk women? The question led Jefferson Health to participate in a clinical trial.   

NRG-CC008, also known as SOROCk, is a national clinical trial available to a particular group of premenopausal women with inherited BRCA1 mutations. As of September 2026, the study is underway, and the team is looking for participants. Women can find trial sites and contact information here. 

“If a woman has a genetic susceptibility to ovarian cancer due to a BRCA1 mutation and is not ready to go into menopause, she may want to participate in this study,” Dr. Edelson says. “The study will determine if removal of the tubes with the plan to remove the ovaries at a later time can reduce the risk of ovarian cancer as much as when they are both removed together.”

“In between, taking out only the tubes is an option, and this is what the study is about,” he adds. 

“We haven’t made many strides in ovarian cancer prevention in the past 20 to 30 years,” Dr. Thomas says. “Now that we’re starting to see data showing a reduction in the development of ovarian cancer due to fallopian tube removal, it’s attracting attention, and there will certainly be more research ahead.”