MISSION-O: Menopausal impact of opportunistic salpingectomy for prevention of ovarian cancer

Research project The aim of this study is to estimate the impact of opportunistic salpingectomy on onset of menopause.

Most ovarian cancers (OC) are now believed to arise from the Fallopian tube. Removing Fallopian tubes at other gynaecologic procedures i.e., opportunistic salpingectomy (OS), is advocated for OC prevention. Previous research has evaluated surgical safety and menopausal symptoms after OS. However, the impact of OS on age at menopause remains unknown as high-quality prospective trial data are lacking. This is critically important, as early menopause and its associated hormonal transition have significant detrimental long-term health consequences.

Head of project

Annika Idahl Associate professor, senior consultant (attending) physician

Email

+46 90 786 73 18

Project overview

Project period:

2026-01-01 – 2029-12-31

Participating departments and units at Umeå University

Department of Clinical Sciences, Department of Public Health and Clinical Medicine

Research area

Clinical medicine

External funding

Region Västerbotten, Swedish Research Council

Project members
Per Liv Statistician

Email

+46 90 786 89 60

External project members
- Ranjit Manchanda, Wolfson Institute of Population Health, Queen Mary University of London, Barts Health NHS Trust, London
- Adam Brentnall, Wolfson Institute of Population Health | Queen Mary University of London
- Sara Knip, Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University
- Caitlin Fierheller, Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Karin Sundfeldt, Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg
- Maria Forslund, Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg
- Jan Brynhildsen, Department of Clinical Sciences, Örebro University
- Sophia Ehrström, Department of Clinical Sciences, Division of Obstetrics and Gynecology, Karolinska Institutet
- Inger Sundström Poromaa, Department of Women's and Children's Health, Uppsala University
- Alexandra Andersson, Nätverket mot gynekologisk cancer
- Annika Strandell, Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg

Project description

Our randomised trial “Hysterectomy and opportunistic salpingectomy” (HOPPSA) evaluates surgical safety and menopausal symptoms after OS. However, the impact of OS on age at menopause remains unknown as high-quality prospective trial data are lacking. This is critically important, as early menopause and its associated hormonal transition have significant detrimental long-term health consequences.

Women in HOPPSA (2,700) will be invited to donate blood samples twice: 1-8 and 2-9 years post-surgery. Sampling will be performed by self-sampling of capillary blood on Dried Blood Spot cards. Differences in serum Follicle stimulating hormone (FSH) distribution between arms will be used to estimate impact on menopause, adjusted for age and time to blood sampling. The mean age difference will be estimated by modelling, using control FSH levels from the Women’s Health Across the Nation (SWAN) cohort study.

Patient benefit

Our study will provide high-quality prospective evidence on impact of OS at hysterectomy on menopausal age. Critically, this will inform clinical guidelines and decision-making for women considering OS in Sweden and world-wide.