title: Risk-reducing salpingectomy in Canada: a survey of obstetrician-gynaecologists.
abstract: OBJECTIVE
  Performing risk-reducing salpingectomy (RRS) at the time of hysterectomy or as a method of tubal ligation has been suggested as a way to reduce the incidence of high grade serous carcinoma (HGSC) of the ovary, since this type of cancer is hypothesized to originate in the fallopian tube. We conducted a survey of Canadian obstetrician-gynaecologists to better understand the uptake and knowledge of implementing this procedure, and to identify barriers to doing so.
  
  
  METHODS
  An anonymous, web-based survey using both quantitative and qualitative methods was sent to obstetrician-gynaecologist members of the Society of Obstetricians and Gynaecologists of Canada and the Society of Gynecologic Oncology of Canada. The survey contained questions about demographics, knowledge and beliefs about RRS, and possible barriers to its implementation in women at average risk for ovarian cancer.
  
  
  RESULTS
  One hundred ninety-two physicians responded to the survey, a response rate of 25%. Respondents varied in their duration in practice, came from all provinces, and spent a large proportion of their time practising gynaecology. Ninety percent of respondents had heard of RRS; however, 37% were unaware of the evidence supporting the hypothesis that HGSC originates in the fallopian tube, and 38% were unsure whether there would be any population benefit from performing RRS at the time of other gynaecologic surgery. Multiple barriers to implementation were identified.
  
  
  CONCLUSIONS
  Most Canadian obstetrician-gynaecologists responding to our survey were aware of RRS as a possible method to prevent ovarian cancer in women at average risk; however, barriers still exist to widespread implementation. Further research is needed to quantify the population benefit of this procedure.
authors.affiliation: Division of Gynaecologic Oncology, Princess Margaret Hospital, Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
authors.forename: Clare J
authors.initials: CJ
authors.lastname: Reade
authors.affiliation: Division of Gynaecologic Oncology, Vancouver General Hospital, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Sarah
authors.initials: S
authors.lastname: Finlayson
authors.affiliation: Division of Gynaecologic Oncology, Vancouver General Hospital, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Jessica
authors.initials: J
authors.lastname: McAlpine
authors.affiliation: Division of Gynaecologic Oncology, Princess Margaret Hospital, Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
authors.forename: Alicia A
authors.initials: AA
authors.lastname: Tone
authors.affiliation: Division of Gynaecologic Oncology, The Ottawa Hospital-General Campus, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa ON.
authors.forename: Michael
authors.initials: M
authors.lastname: Fung-Kee-Fung
authors.affiliation: Division of Gynaecologic Oncology, Princess Margaret Hospital, Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Ferguson
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D018284:Cystadenocarcinoma, Serous / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000523:psychology / Q000706:statistics & numerical data; D006176:Gynecology / Q000379:methods / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011364:Professional Practice; D036301:Qualitative Research; D018570:Risk Assessment; D058994:Salpingectomy / Q000379:methods / Q000706:statistics & numerical data
keywords: high grade serous cancer; ovarian cancer; prevention; salpingectomy