International Journal of Gynecological Cancer · Dec 19, 2025

Opportunistic salpingectomy during gynecologic and non-gynecologic abdominopelvic procedures for ovarian cancer primary prevention: a cost-effectiveness analysis

By Adjei NN, Yeh PG, Haas A et al.

OBJECTIVE: Opportunistic salpingectomy during gynecologic surgeries is associated with a 49% to 77% reduction in ovarian cancer. The impact of the adoption of opportunistic salpingectomy during non-gynecologic abdominopelvic procedures on ovarian cancer-related outcomes is not well-established. We performed cost-effectiveness analyses to assess the impact of opportunistic salpingectomy during 6 common abdominopelvic procedures. METHODS: The cost-effectiveness of opportunistic salpingectomy during laparoscopic hysterectomy, appendectomy, cholecystectomy, gastric bypass, abdominal hernia repair, and colectomy was estimated from the United States single-payer perspective. Markov models were constructed using TreeAge Pro Healthcare software (Version 2023-R1.2) to assess the incremental costs, quality-adjusted life-years, and net monetary benefit associated with opportunistic salpingectomy for each procedure performed for a hypothetical cohort of average-risk United States patients aged 40 years based on the real-world incidence of these procedures within the Merative MarketScan Database. Model inputs were extracted from published literature. Univariate and probabilistic sensitivity analyses were performed. RESULTS: A total of 8633 procedures were identified in MarketScan in 2019 for the hypothetical cohort of 40-year-old patients. Opportunistic salpingectomy during the 6 procedures was incrementally cost-saving ($2176) with more quality-adjusted life-years gained (5.18) from a lifetime perspective, with a net monetary benefit of $520,773. Opportunistic salpingectomy at the time of the 6 procedures for the hypothetical cohort yielded $18.78 million in health care dollars saved, which was derived by multiplying the total number of procedures (8633) by the per-procedure weighted average savings ($2176). Probabilistic sensitivity analyses found that for each procedure, performing opportunistic salpingectomy had less cost and more quality-adjusted life-years gained in over 99% of the 10,000 Monte Carlo simulations. CONCLUSIONS: Widespread adoption of opportunistic salpingectomy during these common abdominopelvic procedures is robustly cost-saving. With no effective general population screening and the high cost and mortality associated with ovarian cancer, performing opportunistic salpingectomy with any of the 6 procedures may be merited.

doi.org/10.1016/j.ijgc.2025.102884 Open access PubMed 41605705 Interventions