Guideline / position statementindependent cross-checkabstract checked I-ORG-142 standard review
US gynaecologists on removing ovaries
Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention (ACOG Committee Opinion No. 774; reaffirmed 2024)
Overview
American College of Obstetricians and Gynecologists (ACOG). ACOG Committee Opinion 2019
Removing both ovaries before menopause may raise risks of heart disease, bone loss, memory problems and death, so it should be discussed carefully.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Guide salpingectomy and oophorectomy counselling
- How was the study done?
Committee opinion
- How many people, animals or samples were studied?
n/a
- What was actually found?
BSO may increase several long-term risks
- How large was the observed effect?
n/a
- What do the results mean in everyday life?
Keeping healthy ovaries is often preferred before menopause
- What are the study's limitations?
Only abstract read
- What does it say about Elawady's specific claim?
Supports the direction of the claim
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Not quantitative
Scientific in-depth review
1. Full reference
- Authors
- American College of Obstetricians and Gynecologists (ACOG)
- Journal
- ACOG Committee Opinion
- Year
- 2019
- Identifier
- Verification
- verified – Official web page fetched 2026-10-26 (https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/04/opportunistic-salpingectomy-as-a-strategy-for-epithelial-ovarian-cancer-prevention)
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
ACOG committee.
2. Research question
Role of opportunistic salpingectomy and counselling on oophorectomy at benign pelvic surgery.
3. Study design and population
- Study design
- Guideline / position statement – Professional society committee opinion (abstract on ACOG web page read)
- Population
Women undergoing pelvic surgery for benign disease
- Country
USA
- Period
April 2019; reaffirmed 2024
- Sample size
Not applicable
- Inclusion and exclusion criteria
Not applicable
4. Methods and endpoints
- Exposure / intervention
Salpingectomy / BSO
- Comparator
n/a
- Endpoints
Recommendations
- Statistical methods
Not applicable
5. Actual results
- Results
Page abstract: bilateral salpingo-oophorectomy that causes surgical menopause reduces the risk of ovarian cancer but may increase the risk of cardiovascular disease, cancer other than ovarian cancer, osteoporosis, cognitive impairment and all-cause mortality; counselling should include an informed-consent discussion about oophorectomy; salpingectomy at hysterectomy appears safe and does not appear to affect ovarian function.
- Absolute risks
Not applicable
- Authors' conclusion
Opportunistic salpingectomy can reduce ovarian cancer risk; oophorectomy risks should be discussed.
6. Strengths
- Professional consensus, reaffirmed 2024
7. Weaknesses
- Only the web abstract read
- Not a systematic GRADE guideline
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Committee opinion.
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
Shows that mainstream gynaecology accepts the potential long-term harms of premenopausal BSO.
11. Independent contrary findings
n/a
12. Transferability to Germany and Europe
Similar European practice.
13. Overall methodological judgement
Supports the claim's direction (ovarian conservation preferred without indication), not its numbers.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
n/a
15. Linked fact checks
- Bilateral oophorectomy at hysterectomy for benign disease increases all-cause mortality, coronary disease and lung cancer — roughly one extra death per nine operations (Parker 2013, Nurses' Health Study). – Studies supporting the claim
- Oophorectomy before menopause raises the risk of cognitive impairment or dementia (HR 1.46), more so the younger the age at surgery (Rocca 2007). – Studies supporting the claim