Self-reported family history of leiomyoma: not a reliable marker of high risk

Abstract

Purpose To examine the importance of self-reported family history of uterine leiomyoma (fibroids) as a marker of risk. Methods Women, aged 35-49, were randomly selected from the membership of a large urban health plan. Participants completed a self-administered questionnaire about family history of fibroids. Ultrasound screening for fibroids followed, regardless of whether participants had been previously diagnosed (660 black, 412 white). Data for each ethnic group were analyzed separately using Poisson regression. Results In both ethnic groups women who reported a family history of fibroids had an elevated risk of fibroids compared to those without family history. However, no elevated risk was apparent for cases who did not know they had fibroids when they reported the family history information. Conclusions Many women may first learn about their family history of fibroids when discussing their own clinical diagnosis with family members. Such bias would invalidate self-reported family history as a predictor of fibroid risk. As new pharmacological treatments for fibroids are developed, women at high-risk of fibroids would benefit from early screening and pharmacologic-treatment to delay development of large fibroids and reduce the need for invasive treatments. Self-reported family history is not useful for identifying high risk women.

Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction

“…Furthermore, it is well known that family history could represent a strong predisposing factor; the first-degree relatives of affected women have a 2.5 times increased risk of developing fibroids [18, 19]. However, as recently reported from Saldana et al, such bias would invalidate self-reported family history as a predictor of fibroid risk [20]. …”

Immunohistochemical Profile of Uterine Leiomyoma With Bizarre Nuclei; Comparison With Conventional Leiomyoma, Smooth Muscle Tumors of Uncertain Malignant Potential and Leiomyosarcoma

“…1 These tumors are the most common uterine neoplasms whereas the malignant counterpart constitutes approximately 1% of uterine malignancies. 2,3 Leiomyoma with bizarre nuclei is a term that has been used for smooth muscle tumors with focal or diffusely distributed multinucleated giant cells in which no coagulative tumor cell necrosis and no increased mitotic activity is seen 4 (Figure 1 C&F). Przybora introduced the term "leiomyosarcoma in situ" for these neoplasms in 1961 for being considerable concern about the giant cell component, 5 however, "Symplastic" and "atypical" leiomyoma are frequently used synonyms for these type of tumors.…”

Pharmacological Activity and Effectiveness of Electrohomoeopathy Medicine on Uterine Fibroids Individuals

“…Moreover, it is well known that family history is a crucial causative factor, with first-degree relations of female patients having a 2.5-fold increased risk of developing fibroids [12] . Such bias, however, would render self-reported family history ineffective as a predictor of fibroid risk, as Saldana et al recently demonstrated [13] . Several studies have found a rapid increase in the incidence of fibroid beyond the age of 30.…”