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MenopauseMISSION-ONCT07423143

Menopausal Impact of Opportunistic Salpingectomy for Ovarian Cancer Prevention

A study testing Opportunistic salpingectomy in people with Menopause and Opportunistic Salpingectomy, run by Umeå University at 1 site in Sweden.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to find out whether removing the fallopian tubes at the time of hysterectomy leads to an earlier menopause. The study includes women under 55 years of age who previously underwent hysterectomy as participants in the HOPPSA trial, where they were randomly assigned to either removal of… Read more about this study

Who is it for?
Ages 20 to 65 years, women only
Conditions the study is for
Menopause, Opportunistic Salpingectomy
What is being tested?
Opportunistic salpingectomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,100 participants
Where
1 siteSweden
Study dates
Mar 2026to Dec 2057
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 65 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Having had hysterectomy for a benign indication
  • Less than 55 years at surgery
  • Was included in the ITT population of the HOPPSA register-based randomised controlled trial (R-RCT) of opportunistic salpingectomy
  • Informed consent

Who cannot join

  • Ongoing systemic hormonal treatment using sex steroids
  • Bilateral oophorectomy
  • Cancer treatment affecting ovarian function
  • Other treatments with major effects on ovarian function

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Annika Idahl, MD, PhD, Professor contact

+46 90 786 73 18

annika.idahl@umu.se

Camilla Ersviken, Trial coordinator contact

mission-o.gyn@umu.se

Sweden1 site
  • Umeå University

    Umeå, 90346

    Sara Knip, MD, sara.knip@umu.se

    Marja-Liisa L Tafvelin, MSc, marjaliisa.lammitavelin@regionvasterbotten.se

Other trials in Sweden

About this study

The goal of this clinical trial is to find out whether removing the fallopian tubes at the time of hysterectomy leads to an earlier menopause. The study includes women under 55 years of age who previously underwent hysterectomy as participants in the HOPPSA trial, where they were randomly assigned to either removal of the fallopian tubes or no removal.

The main question is:

Read more
  • Does removing the fallopian tubes at the time of hysterectomy lead to an earlier menopause? Researchers will compare women who had their fallopian tubes removed during hysterectomy with women who had hysterectomy alone to see whether menopause occurs earlier after tube removal. Age at menopause will be estimated by measuring follicle-stimulating hormone (FSH) in small blood samples collected on a paper card.

Participants will:

  • Collect 4-5 drops of blood using a finger prick
  • Place the drops on a paper card and mail it to the researchers
  • Complete an online questionnaire These steps will be done twice, one year apart.
Read the detailed description

Opportunistic salpingectomy, defined as removal of the fallopian tubes during gynaecologic surgery performed for another indication, has been proposed as a strategy to reduce the risk of ovarian cancer. This approach is supported by accumulating evidence that many high-grade serous ovarian cancers originate in the distal fallopian tube. Although short-term surgical safety has been evaluated in randomized and observational studies, uncertainty remains regarding possible long-term effects on ovarian function.

The HOPPSA randomized trial was initiated to evaluate outcomes after hysterectomy with or without salpingectomy in women undergoing surgery for benign conditions. Previous analyses from this cohort have focused on perioperative safety and patient-reported outcomes. However, the effect of salpingectomy on the timing of menopause has not yet been determined. This question is clinically important because epidemiologic evidence shows that earlier menopause is associated with increased risks of cardiovascular mortality and all-cause mortality, with approximately a 2% relative increase in risk per year earlier menopause. Earlier menopause has also been associated with increased risks of osteoporosis, neurocognitive symptoms, sexual dysfunction, and reduced quality of life. Even modest shifts in menopausal timing could therefore have clinically meaningful long-term health implications.

The relevance of this knowledge gap is underscored by the relatively low lifetime risk of epithelial ovarian cancer in the general population, estimated at approximately 1.3-2%. Modelling studies suggest that between 96 and 148 opportunistic salpingectomy procedures may be required to prevent one ovarian cancer case. Consequently, even small changes in menopausal timing, if present, could influence the overall balance of benefits and risks associated with preventive salpingectomy.

Assessment of menopausal timing after hysterectomy presents methodological challenges because menstrual history cannot be used. Biochemical markers are therefore required. Follicle-stimulating hormone (FSH) is a well-established indicator of ovarian aging and menopausal transition, reflecting declining ovarian follicular activity. Measurement of FSH in blood samples enables estimation of menopausal timing independent of menstrual data.

Capillary blood sampling using self-collected dried blood spots enables biologic measurements in large populations without requiring clinic visits. This approach has been validated for hormone analyses and facilitates long-term follow-up with reduced logistical constraints, thereby supporting high participation and minimizing attrition in longitudinal studies, an important consideration for unbiased estimation of long-term outcomes.

The MISSION-O study uses extended follow-up of participants previously enrolled in the HOPPSA randomized trial to determine whether salpingectomy influences age at menopause. By leveraging a randomized surgical cohort with long-term biologic assessment, this study aims to generate robust evidence regarding the endocrine safety of opportunistic salpingectomy. The findings are expected to inform clinical counselling, individualized risk-benefit assessment, and future clinical guidelines regarding preventive salpingectomy at the time of gynaecologic surgery.

Being tested
Opportunistic salpingectomy
Keywords
opportunistic salpingectomy, hysterectomy, nested trial, randomised controlled trial, RCT, follicle-stimulating hormone, self-sampling, dried blood spot cards

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Opportunistic salpingectomyProcedure or surgery

    Removal of the fallopian tubes at the time of hysterectomy

Study groups in NCT07423143
Study groupRoleWhat they receive
Opportunistic salpingectomyExperimentalSalpingectomy at the time of hysterectomy for a benign reason
Receives: Procedure: Opportunistic salpingectomy
No salpingectomyNo interventionNo salpingectomy at hysterectomy for a benign reason

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Age at menopause

    Evaluated using serum follicle-stimulating hormone (FSH) levels analysed in self-sampled dried blood spots. Continuous outcome measured in years. Samples collected twice one year apart.

    Measured: 1 year

Secondary outcomes (2)
  1. Cardiovascular disease - CVD

    Dichotomous outcome. Diagnosis will be classified according to ICD-10. Data from national health registers will be retrieved. The outcome will be further described according to types of cardiovascular disease, i.e. coronary heart disease and stroke, as well as age at CVD.

    Measured: 10-30 years after enrolment.

  2. Mortality

    Dichotomous outcome, the diagnosis is classified according to ICD-10. Data retrieved from the national Cause of Death Register. Mortality will be further described as all-cause mortality, and mortality due to cardio-vascular disease.

    Measured: 10-30 years after enrolment.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Feb 2026
  2. Study startMar 2026 (estimated)
  3. Primary completionFeb 2029 (estimated)
  4. Study completionDec 2057 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants in the randomised controlled trial HOPPSA (NCT03045965) will be recruited to collect a blood sample by self-sampling twice one year apart.
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
2,100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07423143
Sponsor's protocol ID
MISSION-O-26
Other IDs
2024-06333, RV-1004811, Dnr. 2025-08086-01
Acronym
MISSION-O
Status last verified
Feb 2026
First submitted
12 Feb 2026
Last updated
20 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Under Swedish law, individual-level health data containing potentially identifiable and sensitive patient information cannot be shared publicly. Metadata will be published in a research data repository. Researchers may request access to the data; such requests will be subject to a formal secrecy assessment in accordance with the Swedish Act on Public Access to Information and Secrecy (2009:400) and applicable ethical approvals.

Publications

  • Muka T, Oliver-Williams C, Kunutsor S, Laven JS, Fauser BC, Chowdhury R, Kavousi M, Franco OH. Association of Age at Onset of Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality: A Systematic Review and Meta-analysis. JAMA Cardiol. 2016 Oct 1;1(7):767-776. doi: 10.1001/jamacardio.2016.2415.

    PubMed 27627190
  • Zhu D, Chung HF, Dobson AJ, Pandeya N, Giles GG, Bruinsma F, Brunner EJ, Kuh D, Hardy R, Avis NE, Gold EB, Derby CA, Matthews KA, Cade JE, Greenwood DC, Demakakos P, Brown DE, Sievert LL, Anderson D, Hayashi K, Lee JS, Mizunuma H, Tillin T, Simonsen MK, Adami HO, Weiderpass E, Mishra GD. Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data. Lancet Public Health. 2019 Nov;4(11):e553-e564. doi: 10.1016/S2468-2667(19)30155-0. Epub 2019 Oct 3.

    PubMed 31588031
  • van der Schouw YT, van der Graaf Y, Steyerberg EW, Eijkemans JC, Banga JD. Age at menopause as a risk factor for cardiovascular mortality. Lancet. 1996 Mar 16;347(9003):714-8. doi: 10.1016/s0140-6736(96)90075-6.

    PubMed 8602000
  • Piek JM, Schauwaert J, Ellis LB, Zapardiel I, Planchamp F, Koblos K, Kacperczyk-Bartnik J, Bowden SJ, El Hajj H, Grigore M, Steenbeek MP, Bizzarri N, Kyrgiou M, Gultekin M. Opportunistic Salpingectomy for Prevention of Tubo-Ovarian Carcinoma: The European Society of Gynaecological Oncology Consensus Statements. JAMA. 2026 Mar 10;335(10):894-902. doi: 10.1001/jama.2025.24510.

    PubMed 41627806
  • Idahl A, Darelius A, Sundfeldt K, Palsson M, Strandell A. Hysterectomy and opportunistic salpingectomy (HOPPSA): study protocol for a register-based randomized controlled trial. Trials. 2019 Jan 5;20(1):10. doi: 10.1186/s13063-018-3083-8.

    PubMed 30611296
  • Idahl A, Liv P, Darelius A, Collins E, Sundfeldt K, Palsson M, Strandell A. HOPPSA update: changes in the study protocol of Hysterectomy and OPPortunistic SAlpingectomy, a registry-based randomized controlled trial. Trials. 2023 Mar 24;24(1):222. doi: 10.1186/s13063-023-07244-w.

    PubMed 36959664
  • Magarakis L, Idahl A, Sundfeldt K, Liv P, Palsson M, Strandell A. SALpingectomy for STERilisation (SALSTER): study protocol for a Swedish multicentre register-based randomised controlled trial. BMJ Open. 2023 Sep 4;13(9):e071246. doi: 10.1136/bmjopen-2022-071246.

    PubMed 37666548
  • Collins E, Strandell A, Granasen G, Idahl A. Menopausal symptoms and surgical complications after opportunistic bilateral salpingectomy, a register-based cohort study. Am J Obstet Gynecol. 2019 Jan;220(1):85.e1-85.e10. doi: 10.1016/j.ajog.2018.10.016. Epub 2018 Oct 12.

    PubMed 30321526

Questions about this trial

What is this clinical trial studying?

A study testing Opportunistic salpingectomy in people with Menopause and Opportunistic Salpingectomy, run by Umeå University at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 20 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Annika Idahl, MD, PhD, Professor (+46 90 786 73 18, annika.idahl@umu.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Age at menopause (time frame: 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07423143, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Feb 2026.

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