Xia Wei, Samuel Oxley, Ranjit Manchanda et al. Cancers 2022, 14, 6117
This systematic review found that surgical prevention is cost-effective for women in high-income countries who are at a high risk of breast cancer, intermediate/high risk of ovarian cancer and high risk of endometrial cancer. Synthesized cost-effectiveness evidence is necessary for resource allocation for risk-reducing surgery in breast cancer (BC)/ovarian cancer (OC)/endometrial cancer (EC) prevention strategies. From 22 included studies, risk-reducing mastectomy (RRM) and/or risk-reducing salpingo-oophorectomy (RRSO) were cost-effective for BRCA1/2, and RRSO was also cost-effective at a lower lifetime OC risk-threshold of 4–5%. Risk-reducing early salpingectomy and delayed oophorectomy (RRESDO) was cost-effective compared to RRSO in one-study. Hysterectomy with bilateral salpingo-oophorectomy (BSO) was cost-effective in Lynch syndrome women. Opportunistic bilateral salpingectomy (OBS) was cost-effective when conducted with hysterectomy for benign gynecology surgery or in lieu of tubal sterilization. This systematic review found that surgical prevention is cost-effective for women who are at high risk of BC, intermediate/high risk of OC and high risk of EC. Risk-reducing surgery is cost-effective for breast/ovarian/endometrial cancer prevention across most settings, but more research is needed on the disutility from all preventive surgery and the precision in terms of the cancer risk reduction from salpingectomy.
15 Apr, 2026