Does ovarian removal prevent ovarian cancer?

Ovarian cancer is the fifth most deadly cancer in women, with little improvement in overall survival over the past 50 years. Aggressive epithelial ovarian cancer represents 75% of ovarian cancers and causes 90% of ovarian cancer-related deaths. There is currently no reliable and effective screening program for ovarian cancer. Recent theories suggest that serous, endometrioid, and clear cell ovarian cancers originate in the fallopian tubes and endometrium rather than directly in the ovaries.

In women with a genetic predisposition to ovarian cancer, lesions that closely resemble high-grade serous ovarian carcinoma or serous tubal intraepithelial carcinoma have been found in the fallopian tubes. These carcinomas are considered the source of ovarian cancer. The fallopian tube lesions express TP53 mutations that resemble high-grade serous carcinoma, high-grade endometrioid carcinoma, and undifferentiated carcinoma. In addition, the gene expression of high-grade serous carcinoma is also highly correlated with the fallopian tube morphology, rather than the ovarian epithelium.
High-grade serous carcinomas express the müllerian marker (PAX8) but lack the mesothelial marker (calretinin). Previous studies have found that tubal ligation has a protective effect against endometrioid carcinoma and clear cell carcinoma.