Peer Networks Drive Physician Adoption of Opportunistic Salpingectomy

A new national analysis reveals that physician peer networks play a significant role in how quickly clinicians adopt opportunistic salpingectomy—a preventive strategy recommended to reduce ovarian cancer risk during hysterectomy.

Following professional society recommendations to counsel patients on opportunistic salpingectomy, overall uptake has risen in recent years. However, adoption varies widely across physicians. This study aimed to understand whether peer influence helps explain these differences.

Study Overview
Using Blue Cross Blue Shield Axis claims data across the United States, researchers examined women aged 18–49 who underwent inpatient hysterectomy from 2019 to 2022. Opportunistic salpingectomy was defined as bilateral fallopian tube removal without oophorectomy.

Physician peer relationships were established based on shared patient care in 2017–2018. Investigators then measured whether a physician’s exposure to peers with higher salpingectomy utilization influenced their own practice patterns in later years.

Key Findings
• Among3373 hysterectomy patients, 55.5% received opportunistic salpingectomy.
• Physicians exposed to peers with high baseline salpingectomy rates were far more likely to perform the procedure themselves.
– Salpingectomy rates were highest when peer physicians were in the top quartile (64.5%) or second quartile (59.6%), compared with 44.0% in the lowest quartile (P<.001).
• After adjusting for clinical and demographic variables, peer influence remained strong:
– Highest-quartile peer exposure: OR 1.99 (95% CI 1.46–2.71)
– Second-highest quartile: OR 1.64 (95% CI 1.21–2.22)

Conclusion
Physicians are significantly influenced by their professional networks when adopting new preventive surgical practices. Those who share patients with colleagues who frequently perform opportunistic salpingectomy are nearly twice as likely to incorporate the technique into their own hysterectomy practice.

These findings highlight the potential of peer-driven strategies, such as targeted education within physician networks, to accelerate the uptake of opportunistic salpingectomy and strengthen ovarian cancer prevention efforts.