A Prospective, Ultrasound-Based Study to Evaluate Risk Factors for Uterine Fibroid Incidence and Growth: Methods and Results of Recruitment

Abstract

Background: Uterine fibroids are common, benign, smooth-muscle tumors that can cause major morbidity for reproductive-age women, often requiring invasive treatment. Despite this personal and public health burden, no prior study has attempted to periodically screen fibroid-free women with ultrasound to detect incident disease and identify risk factors. Methods: We designed a study to prospectively investigate development of fibroids by enrolling women without a clinical diagnosis of fibroids and screening for fibroids with ultrasound at baseline. Enrollment procedures included extensive questionnaires and specimen collection (blood, urine, vaginal swabs). The cohort is followed at approximately 20-month intervals. At each follow-up there are updates to the questionnaire data, further specimen collection, and an ultrasound examination. We identify incident disease and measure tumor growth. The two exposures of primary interest are vitamin D insufficiency and reproductive tract infections. This manuscript provides a detailed description of the study methods, recruitment results, and participant characteristics. Results: The Study of Environment, Lifestyle and Fibroids enrolled 1,696 African American women aged 23-34 years. ''Family and friends'' was a leading recruitment source. More than 95% of participants contributed all the requested biological specimens at baseline. Study ultrasound examinations revealed undiagnosed fibroids in 378 women (22% of participants). The retention rate for the first follow-up was 87%. Conclusions: Study design aspects likely to be important for long-term studies in young African Americans include personalized recruitment, multiple steps to the enrollment process that rely on the initiative of the participant, and methods for tracing highly mobile study subjects.

Chlamydia trachomatis Seroprevalence and Ultrasound-Diagnosed Uterine Fibroids in a Large Population of Young African-American Women

“…In contrast, development of fibroids was likely to occur relatively later. Fibroids are rarely seen in African Americans before the mid-20s (22,29), and most of the fibroids detected in our study were small, suggesting new development.…”

“…SELF is a prospective cohort study of fibroid development; however, only baseline fibroid data were available at the time of this analysis. Enrollment data and specimen collection protocols have been described previously (22). In brief, from November 2010 to December 2012, the investigators recruited 1,696 AfricanAmerican female volunteers aged 23-34 years.…”

“…As described previously (22), fibroids were assessed by study sonographers with transvaginal ultrasonography, the standard procedure for the detection and diagnosis of fibroids (23), at one of 3 Henry Ford Health System clinics. Focal fibroids 0.5 cm or more in diameter were measured in triplicate.…”

Self-reported bacterial vaginosis and risk of ultrasound-diagnosed incident uterine fibroid cases in a prospective cohort study of young African American women

“…We used transvaginal ultrasound results and self-reported questionnaire data from participants in the ongoing National Institute of Environmental Health Sciences (NIEHS) Study of Environment, Lifestyle & Fibroids (SELF) described previously 15 . In brief, starting in 2010, the study enrolled a volunteer sample of 1,695 African-American women ages 23–34 living in the Detroit, Michigan area.…”

Possibilities of Mifepristone Use After Surgical Therapy of Uterine Myoma

“…В США распространенность миомы матки в возрасте от 18 до 30 лет, не имеющей клинических про-явлений, составляет 43-57% [4]. Доказано, что миому матки диагностируют у каждой пятой женщины с бес-плодием, хотя само заболевание не рассматривают как ведущую причину нарушения фертильности [5]. Лечение миомы матки -предмет пристального внимания как мировой, так и отечественной гинекологии.…”