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No. Removing both ovaries can greatly reduce the risk of ovarian cancer, especially for people with certain inherited cancer risks, but it does not make the risk of related cancer zero. A small risk of primary peritoneal cancer can remain after risk-reducing surgery. The fallopian tubes matter too: many high-grade serous cancers are thought to begin there, which is why risk-reducing surgery is commonly discussed as removal of both tubes and ovaries rather than the ovaries alone.
What cancer risk remains after ovary removal?
After a risk-reducing bilateral salpingo-oophorectomy (often shortened to BSO), a person may still develop primary peritoneal cancer. The peritoneum is the lining of the abdominal cavity. This cancer is distinct from ovarian cancer, even though it can be similar in type and may be discussed alongside ovarian and fallopian-tube cancers.
The National Cancer Institute (NCI) describes this remaining risk as small. It may arise if cancer cells had already spread beyond the ovaries before surgery, or if some ovarian tissue remains. Removing the organs therefore changes risk substantially; it cannot guarantee that no related cancer will develop.
Why do doctors discuss the fallopian tubes as well as the ovaries?
Ovarian cancer is not one disease with a single point of origin. Evidence cited by the American College of Obstetricians and Gynecologists (ACOG) connects many high-grade serous cancers—the most common and aggressive type of ovarian cancer—to the fallopian tubes. Other ovarian cancers, including some nonepithelial cancers, can originate in the ovary.
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The terms describe different operations:
- Salpingectomy: removal of the fallopian tubes.
- Oophorectomy: removal of one or both ovaries.
- Salpingo-oophorectomy: removal of the fallopian tubes and ovaries; bilateral means both sides.
ACOG says opportunistic salpingectomy—removing the tubes when someone is already having pelvic surgery for another reason—can lower ovarian cancer risk, but does not eliminate it. That statement concerns tube removal, not removal of both ovaries. These procedures are not interchangeable, and the appropriate choice depends on individual risk and circumstances.
How much can risk-reducing surgery lower risk?
The clearest figure in the cited guidance is specific to people with an inherited risk: the NCI professional prevention summary reports a 90% reduction in ovarian cancer risk observed among women with a BRCA1 or BRCA2 mutation after risk-reducing bilateral salpingo-oophorectomy. The NCI page does not state the year for this estimate. It is an observed reduction in a defined group, not a guarantee for an individual and not an estimate for everyone.
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A separate family-based BRCA study summarized by the NCI illustrates both the benefit and the residual risk. Among 259 women who had prophylactic bilateral oophorectomy, 2 (0.8%) later developed papillary serous peritoneal carcinoma, and 6 (2.8%) had stage I ovarian cancer found at surgery. Matched controls had a 20% occurrence of ovarian cancer; over an average follow-up of nine years, surgery was associated with a risk reduction exceeding 90%. These are results from that particular study, not universal rates. The NCI notes that family-based studies can have selection and other biases, and the cited passage does not give the study’s publication year.
Risk estimates from different operations should not be mixed. In an observational Swedish study reported in ACOG’s April 2019 Committee Opinion, bilateral salpingectomy was associated with 65% lower ovarian cancer risk and sterilization with 28% lower risk compared with the study’s reference group. Those figures concern those procedures and that study; they are not estimates of the effect of removing both ovaries.
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What are the trade-offs of removing both ovaries?
If both ovaries are removed before natural menopause, the operation causes immediate menopause. Symptoms can include hot flashes, sleep or mood changes, and vaginal or sexual symptoms. Earlier loss of ovarian hormones can also affect longer-term health, including bone and cardiovascular health. The timing and impact vary, so these effects should be part of a clinician-led discussion alongside cancer risk.
For someone with a known pathogenic variant or a concerning family history, a decision about risk-reducing surgery involves more than a population statistic. Age, menopause status, personal and family history, the specific genetic finding, and surgical circumstances all matter. A clinician experienced in hereditary cancer risk or gynecologic oncology can help assess those factors and discuss the benefits, harms, and timing. Surgery performed to treat an existing cancer is a different situation from preventive surgery in someone without a diagnosis.
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Can screening replace surgery or guarantee early detection?
No screening test guarantees that ovarian cancer will be found early. ACOG says transvaginal ultrasound and CA-125 blood testing have not been shown to reduce mortality when used to screen average-risk women. False-positive results can lead to anxiety and follow-up procedures or surgery that have their own harms. Screening recommendations and evaluation are different for people with symptoms or elevated inherited risk; an individual plan should come from a clinician rather than relying on routine screening as a substitute for risk assessment.
Four common claims, clarified
- “Removing the ovaries means related cancer can never happen.” Not true: primary peritoneal cancer risk remains after risk-reducing surgery.
- “All ovarian cancers start in the ovary.” Not accurate: many high-grade serous cancers are thought to arise in the fallopian tube, though some cancers do originate in the ovary.
- “Risk reduction has no cost.” Premenopausal removal of both ovaries causes immediate menopause and can have longer-term health effects.
- “A normal CA-125 or ultrasound rules out future disease.” These tests have not been shown to reduce mortality as screening for average-risk women.
The evidence supports these clarifications, but it does not establish a particular “eight myths” list or verify a named oncologist connected with that framing. The useful distinction is between reducing risk and eliminating it: bilateral tube-and-ovary removal can be an important preventive option for some people, but it is not an absolute guarantee.
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