High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence.
Level 3 - non-randomized controlled study
Non-randomized comparative screening cohort study
PubMed 12548202 · doi:10.1067/mob.2003.99
What was done
Randomly selected members of an urban health plan aged 35 to 49 years (n = 1364) were evaluated to estimate the age-specific proportion of Black and White women with uterine leiomyoma (fibroids). Premenopausal participants underwent screening ultrasonography independently of clinical symptoms. Women who were no longer menstruating (predominantly due to prior hysterectomies) were assessed using medical records and self-report.
What was found
Among premenopausal women, 35% had a prior diagnosis of fibroids, and 51% of those without a prior diagnosis showed ultrasound evidence of fibroids upon screening. By age 50, estimated cumulative incidence of fibroids was >80% for Black women and nearly 70% for White women. Black women had a significantly higher age-specific cumulative incidence compared with White women (odds ratio, 2.9; 95% CI, 2.5-3.4; P < .001).
Why it matters
This study establishes that most women develop uterine fibroids before menopause, with substantially earlier onset and higher cumulative incidence among Black women compared to White women.
Limits
The study was conducted within a single urban health plan among insured women aged 35 to 49, which may limit generalizability. Ascertainment for non-menstruating women relied on self-report and medical records rather than standardized ultrasound examination, and other racial and ethnic groups were not analyzed.
Cited by
- supports Approximately 80 percent of women will develop uterine fibroids by age 50.