Potential Risk Factors Associated With Subtypes of Uterine Leiomyomata

Dragomir, Anca; Schroeder, Jane C.; Connolly, AnnaMarie; Kupper, Larry L.; Hill, Michael C.; Olshan, Andrew F.; Baird, Donna D.

doi:10.1177/1933719110376979

Cited by 36 publications

(25 citation statements)

References 20 publications

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“…31,32 The Uterine Fibroid Study evaluated risk factors with different sub-types of uterine leiomyomata categorized by tumor location (submucosal, intramural, subserosal, and diffuse disease); this study demonstrated increased risk of diffuse uterine leiomyomatosis in tobacco smokers. 33 However comparisons between air pollution exposures and tobacco exposures must be undertaken cautiously as studies have suggested that tobacco smoke has an anti-estrogenic effect, 34,35 where limited in vitro studies have suggest estrogenic effects of air pollution. 16 …”

Section: Discussionmentioning

confidence: 99%

Air Pollution and Risk of Uterine Leiomyomata

et al. 2014

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Background Air pollution, particularly from vehicle exhaust, has been shown to influence hormonal activity. However, at present, it is unknown whether air pollution exposure is associated with the occurrence of uterine leiomyomata, a hormonally sensitive tumor of the uterus. Methods Proximity to major roadways and outdoor levels of PM less than 10 microns (PM10) or 2.5 microns (PM2.5) or between 10 and 2.5 microns (PM10–2.5) in diameter were determined for all residential addresses from September 1989 to May 2007 for 85,251 women aged 25–42 at enrollment in the Nurses’ Health Study II who were alive and responding to questionnaires, premenopausal with intact uteri, without diagnoses of cancer, or prevalent uterine leiomyomata. Incidence of ultrasound- or hysterectomy-confirmed uterine leiomyomata and covariates were reported on biennial questionnaires sent through May 2007. Multivariable time-varying Cox proportional hazard models were used to estimate the relation between distance to road or PM exposures and uterine leiomyomata risk. Results During 837,573 person-years of follow-up, there were 7,760 incident cases. Living close to a major road and exposures to PM10 or PM10–2.5 were not associated with an increased risk of uterine leiomyomata. However, each 10 µg/m3 increase in 2-year average, 4-year average, or cumulative average PM2.5 was associated with an adjusted hazard ratio (HR) of 1.08 (95% confidence interval (CI):1.00–1.17), 1.09 (95%CI:0.99–1.19) and 1.11 (95%CI:1.03–1.19), respectively. Conclusions Chronic exposure to PM2.5 may be associated with a modest increased risk of uterine leiomyomata.

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Section: Discussionmentioning

confidence: 99%

Air Pollution and Risk of Uterine Leiomyomata

et al. 2014

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“…Because mitotic activity in the myometrium is greatest during the luteal phase of the menstrual cycle [74], a longer history of cycling would be expected to increase UL risk. In support of this, most studies have shown that UL risk increases with earlier age at menarche [22, 29, 75–81]. No studies have investigated the relation between late age at menopause and risk for UL.…”

Section: Etiologic Hypotheses and Risk Factorsmentioning

confidence: 99%

“…However, more recent case-control [79, 88] and prospective cohort studies [23, 97] find no such association. In the UFS, there was a positive relation of smoking with diffuse UL but not with submucosal or intramural/subserosal UL [81]. Tobacco components may inhibit aromatase [106] and shift estradiol metabolism toward less potent forms of estrogen [107, 108].…”

Section: Etiologic Hypotheses and Risk Factorsmentioning

confidence: 99%

Epidemiology of Uterine Fibroids

Wise

Laughlin-Tommaso

2016

Clinical Obstetrics &Amp; Gynecology

278

122

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Uterine leiomyomata (UL) have a substantial impact on women's health, but relatively few studies have identified opportunities for primary prevention of these neoplasms. Most established risk factors are not modifiable, including premenopausal age, African ancestry, age at menarche, and childbearing history. The main challenge in studying UL is that a large proportion of tumors are asymptomatic. Herein, we review the epidemiology of UL from published studies to date. We highlight the advantages of ultrasound screening studies and the ways in which their innovative methods have helped clarify the etiology of disease. We conclude with a discussion of promising new hypotheses.

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“…1 Although benign, they can be a chronic condition for many women, as clinical symptoms may be present in up to 50% of those affected. 2,3 These symptoms can include heavy menstrual bleeding, prolonged periods, pelvic pressure symptoms, and reproductive dysfunction. 4 This significant morbidity during a woman's reproductive years has made fibroids the leading cause of hysterectomy in the United States.…”

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confidence: 99%

An Altered Perception of Normal: Understanding Causes for Treatment Delay in Women with Symptomatic Uterine Fibroids

Ghant

Sengoba

Vogelzang

et al. 2016

Journal of Women's Health

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Background: Uterine fibroids are benign tumors that are the leading cause of hysterectomy in the United States. Despite their high prevalence and associated morbidity, there are little qualitative data characterizing what drives women's treatment-seeking behavior for their fibroids. Methods: Women with symptomatic or recently treated uterine fibroids completed in-depth interviews and demographic surveys. Interviews were transcribed verbatim and uploaded to NVivo version 10 for data management and thematic coding. Coders identified major themes and subthemes that emerged from the interviews. Results: Sixty women (n = 60) completed the interviews. The kappa among coders was 0.94. The mean age of participants was 43.0 -6.8. 61.7% of participants self-identified as African American, 25.0% as Caucasian, 8.3% as Hispanic, and 5.0% as Asian. Many women reported obtaining a delayed diagnosis for their uterine fibroids despite experiencing severe symptoms. There were five subthemes that identified why women delayed seeking treatment, which included the perception that their symptoms were ''normal,'' they had a low knowledge of fibroids, they did not perceive themselves to be at risk for fibroids, they engaged in avoidancebased coping strategies, and/or they dissociated themselves from their fibroids. Conclusions: Many women with symptomatic fibroids live with this condition chronically without seeking care. It appears that for some, limited knowledge regarding fibroids and normal menstruation may lead to a distorted view of what is normal with regard to uterine bleeding, resulting in limited treatment seeking behavior. Others know their symptoms are abnormal but simply avoid the problem. There is a need for patient-centered and community-based education to improve women's knowledge of fibroids and symptoms and to promote treatment options.

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Potential Risk Factors Associated With Subtypes of Uterine Leiomyomata

Abstract: Although the 2 focal UL subtypes had similar risk factor profiles, the diffuse UL subtype appeared to have a distinctive risk profile with regard to current smoking. Further study of the diffuse heterogeneity seen with uterine ultrasound is needed.

Cited by 36 publications

References 20 publications

Air Pollution and Risk of Uterine Leiomyomata

Air Pollution and Risk of Uterine Leiomyomata

Epidemiology of Uterine Fibroids

An Altered Perception of Normal: Understanding Causes for Treatment Delay in Women with Symptomatic Uterine Fibroids

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