Ovarian cancer is a leading cause of cancer-related deaths among women. Although the incidence of ovarian cancer in the general population is only 1–2 %, most patients are diagnosed at an advanced stage due to a lack of symptoms and screening tests. The 5-year overall survival rate for ovarian cancer was 50.9 % from 2014 to 2020, and among those with stage III or IV disease, 5-year overall survival was 31.4 % [1]. In contrast, breast cancer, the most common cancer among women, had a 5-year overall survival rate of 91.2 % during the same period [2].

Within histologic subtypes of epithelial ovarian cancer (EOC), high-grade serous ovarian cancer (HGSOC) accounts for approximately 75 % of new diagnoses and, due to its prevalence and aggressive nature, is responsible for most ovarian cancer–related deaths [3]. One of the most significant discoveries in the past 25 years regarding HGSOC is that it originates from the fimbriae of the fallopian tube rather than the ovarian surface epithelium. While first recognized in women with BRCA1 and BRCA2 pathogenic variants found to have serous tubal intraepithelial carcinomas (STICs) in their fallopian tubes at the time of risk-reducing salpingo-oophorectomy, the prevalence and clinical relevance of STIC lesions among average-risk women remains less well defined [4,5].

The discovery that HGSOC originates from the fallopian tube, along with the estimated prevalence of STIC lesions, has prompted several studies investigating the impact of bilateral salpingectomy on ovarian cancer risk, which consistently demonstrated risk reduction of 42–65 % [[6], [7], [8], [9], [10]]. Based on this compelling evidence, opportunistic salpingectomy has been established as an option for risk reduction among women at average risk for ovarian cancer. Opportunistic salpingectomy is recommended as the standard of care during benign gynecologic surgery among women who have completed child-bearing and tubal sterilization procedures [[11], [12], [13]]. Studies have demonstrated that opportunistic salpingectomy is associated with minimal perioperative adverse events, few minor surgical complications, no earlier onset of menopause, and is cost-effective for ovarian cancer risk reduction [[14], [15], [16], [17], [18]]. To expand the reach of ovarian cancer risk reduction among average-risk women, opportunistic salpingectomy is now being considered during non-gynecologic abdominal/pelvic surgeries, such as colorectal surgery and general surgery. The aim of this study was to determine the proportion of patients diagnosed with HGSOC who had undergone prior abdominal or pelvic surgery who may have benefited from opportunistic salpingectomy. We additionally determined the proportion of those diagnosed with HGSOC that were unknowingly high-risk germline HBOC PV carriers at the time of their opportunistic surgery.