Comparison of characteristics of fibroids in African American and white women undergoing premenopausal hysterectomy

Abstract

Objective To compare pathologic characteristics and epidemiologic risk factors for uterine fibroids in African American and white women undergoing hysterectomy. Design Cross-sectional analysis of women undergoing pre-menopausal hysterectomy. Setting Two university-associated hospitals in North Carolina. Patients African American (n=225) and white women (n=135) with fibroid diagnosis. Interventions None Main Outcome Measures Data were obtained from an in-person interview and abstracted from operative and pathologic reports. Analysis of variance and multiple linear regression models were used to identify characteristics associated with higher uterine weight, greater number of fibroids and size of largest fibroid. Results African American women had substantially more fibroids (9.9 versus 4.5) with a concomitant higher mean uterine weight (477 versus 267 grams). Although African American women had a higher prevalence of established risk factors for fibroids such as high body mass index and hypertension, these factors were not associated with larger uteri or more numerous fibroids. In multiple linear regression models, the only factors statistically significantly associated with higher uterine weight, larger fibroids and more numerous fibroids were race and nulligravidity. Conclusions The presentation of fibroids as measured by uterine size or number of fibroids is more severe in African American women as compared to white women. The differences in presentation cannot be explained by racial differences in the prevalence of known risk factors; additional research is needed on environmental and genetic factors that may increase risk for fibroids.

Vitamin D and uterine leiomyoma among a sample of US women: Findings from NHANES, 2001–2006

“…This study is also unique because it includes women over a wider age range (20–54 years) and includes those who had undergone hysterectomies. Because hysterectomy is used to treat UL [7] excluding women with hysterectomy leaves open the question of whether Vitamin D and UL are associated in women who underwent hysterectomy, who perhaps had more serious symptoms or more advanced cases. Excluding women with hysterectomy may also alter the population under study so that it no longer matches the base population of women with UL, as about 250,000 women with UL choose to undergo hysterectomy every year [40].…”

The health disparities of uterine fibroid tumors for African American women: a public health issue

“…Fibroids tend to be more numerous and larger among African American patients undergoing hysterectomy (26,27), which increases their risk of blood transfusion and postsurgical complications such as infection and bleeding. However, there are no corresponding data on racial differences in disease burden before other fibroid therapies or at the time of diagnosis.…”

Hearing the Silenced Voices of Underserved Women

“…Quantitative research has identified multiple differences in pathology (e.g., uterine size and weight, number of fibroids, age at diagnosis, and time between diagnosis and surgery), risk factors (e.g., obesity, history of hypertension, family history of fibroids), and potential sequelae (e.g., infertility; heavy menses; disruption in physical activities, relationships, and work) between AAW and CW. 54,55 It is likely that the aforementioned differences as well as other demographic and cultural differences would influence AAW’s lived experience with fibroids; thus AAW’s voices with regard to fibroids warrant attention.…”