Abstract IA016: Opportunistic salpingectomy for ovarian cancer prevention
Notice bibliographique
Résumé
Abstract In those at high risk for ovarian cancer, particularly people with a BRCA1/2 mutation, bilateral salpingo-oophorectomy is recommended, which reduces the risk of ovarian or fallopian tube cancers by 80%. However, removal of the ovaries is not recommended for the general population, as it is associated with increased total mortality, coronary heart disease, and osteoporosis. Thus, a different preventive strategy is needed for people at average risk, who make up 80% of cases of HGSCs. The recent understanding that HGSC often originates in the fallopian tube, has led to a primary prevention opportunity for the general population, namely, opportunistic salpingectomy (OS). Opportunistic salpingectomy (OS), the removal of fallopian tubes during hysterectomy or instead of tubal ligation without removal of ovaries, is recommended to prevent ovarian cancer, particularly serous ovarian cancer. This recommendation was made in British Columbia, Canada in 2010 and has been followed by similar recommendations in at least nine other countries worldwide, including the United States. Since the 2010 recommendation in British Columbia, we have used population-based data available in our province to study the safety, cost-effectiveness and most recently, the effectiveness of OS for ovarian cancer prevention. The safety data for OS has been reassuring. HIstorical data have suggested decreased risk among those without fallopian tubes; however, we hypothesized that OS confers more protection than salpingectomies done for diseases that directly impact and distort the fallopian tube, as the intent of OS is complete removal of the fimbriated end of the fallopian tube, which may not occur when salpingectomy is done for other indications. Our recent examination of prospective data of OS in British Columbia revealed of the 25,889 people who had OS (mean age 40.2 years, median follow-up 3.2 years) and 32,080 who had hysterectomy alone or tubal ligation (mean age 38.2 years, median follow-up 7.3 years) during our study period (2008-2017), there were no serous ovarian cancers in the OS group and £5 epithelial ovarian cancers. The age-adjusted expected number was 5.27 (95% CI 1.78, 19.29) serous cancers and 8.68 (95%CI 3.36, 26.58) epithelial ovarian cancers. Age-adjusted expected vs observed numbers of breast (22.1 expected, 23 observed) and colorectal (9.35 expected, 8 observed) cancers were not statistically significant different. Thus, the statistically significantly fewer serous and epithelial ovarian cancers seem to be a result of the OS and not due to unmeasured confounding that reduced cancer risk in general. Future research includes: 1) ensuring that all those eligible for OS are counselled about it; 2) expanding opportunities for OS to include other pelvic surgeries; and 3) targeting risk-reducing salpingectomy to individuals at higher than average lifetime risk for ovarian cancer despite not having a known genetic mutation that increases risk. Through this combination the incidence of ovarian cancer may be reduced in the future. Citation Format: Gillian E. Hanley. Opportunistic salpingectomy for ovarian cancer prevention [abstract]. In: Proceedings of the AACR Special Conference on Ovarian Cancer; 2023 Oct 5-7; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_2):Abstract nr IA016.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,024 | 0,004 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».