Almost all ovarian cancers begin, not in the ovaries, but in the fallopian tubes attached to them, find a study. Ovarian cancer is more aggressive than many other cancers because it is hard to diagnose in its earliest, and most treatable, stages. Fallopian tubes enable egg cells that have the potential to be fertilized and become embryos to pass from the ovaries, where they are made, to the uterus. The findings showed that ovarian cancer cells have more in common with cells covering the tips of fallopian tubes than with those on the surface of ovaries. If biomarkers can be found for these tubal cells, future blood tests, advanced Pap smears, or direct tests on tubal tissue might be able to detect ovarian cancer earlier, the researchers noted. Further, the study also points to the possibility that removing a woman’s fallopian tubes, but not her ovaries, may reduce risk of ovarian cancer in those at high risk for disease, including those with genetic changes (mutations) known to increase risk (for example BRCA gene). “Based on a better understanding of its origins, our study suggests new strategies for the prevention and early detection of ovarian cancer,” said Douglas A. Levine, professor at the NYU School of Medicine. “The study seeks to determine whether removing the tubes improves quality of life, compared to removing both the tubes and ovaries,” Levine added, in the paper published in the journal Nature Communications. However, it not yet clears that whether or not the cells that become ovarian cancer become malignant in the fallopian tubes or if they circulate to other organs first. For the study, the team conducted in-depth molecular analyses of cells from 96 women with high-grade serous carcinoma. The results failed to identify any genetic differences between cancer cells arising in the tubes and serous “ovarian” cancers occurring elsewhere in the pelvis. “We found no differences in the 20,000 genes that we can identify. This leads us to believe that that these ovarian cancers all originate in the fallopian tubes,” says Levine.