Epidemiology of uterine fibroids: a systematic review

Abstract

Background Uterine fibroids (UFs) are the most common neoplasm affecting women that can cause significant morbidity and may adversely impact fertility.Objectives To examine UF epidemiology and to evaluate the relative strengths of putative risk factors.Search strategy MEDLINE and Embase were searched for studies published in English between January 1995 and April 2015.Selection criteria Publications reporting relevant data from registries and other observational studies with over 1000 patients and single-centre studies with over 100 patients were selected.Data collection and analysis Data on UF incidence, prevalence and associated risk factors were extracted from 60 publications.Main results Wide ranges were reported in both UF incidence (217-3745 cases per 100 000 women-years) and prevalence (4.5-68.6%), depending on study populations and diagnostic methods. Black race was the only factor that was recurrently reported to increase UF risk, by two-threefold compared with white race. Eleven other factors affected UF risk to a magnitude similar to or greater than race. Age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption increased UF risk; use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate, smoking in women with low body mass index and parity reduced UF risk.Conclusions We identified 12 risk factors that play an important role in UF epidemiology. The UF risk factor with the strongest evidence is black race. High-quality prospective observational data are needed to improve our understanding of UF epidemiology, and thus its aetiology and optimal management.Keywords Epidemiology, incidence, leiomyoma, prevalence, race, risk factors, uterine fibroids.Tweetable abstract Uterine fibroids occur in about 70% of women. Black race and 11 other factors affect uterine fibroid risk.

Bisphenol A promotes the proliferation of leiomyoma cells by GPR30‐EGFR signaling pathway

“…The incidence is increasing continuously and surgical treatment is still the most common treatment strategy. However, that can affect patients’ physical and psychological health . Recent decades has witnessed the progression on discovering the pathogenic factors that are related to leiomyoma including the environmental, genetics, hormonal and growth factors as well as some hormone‐related factors .…”

Epidemiology and management of uterine fibroids

“…The prevalence of fibroids has been historically underestimated by epidemiologic studies which focused mainly on symptomatic women, leaving behind a large population of asymptomatic women and women who underreport their symptoms . The prevalence of fibroids varies among different studies and countries (4.5%–68.6%) based on the type of investigation, method of diagnosis, and racial/ethnic demographics of the population studied . Recent research from the United States has shown that fibroids are detected by ultrasound in more than 80% of women of African ancestry and nearly 70% of white women by the age of 50 .…”

Childbearing at very advanced maternal age, the challenges and complications: A report of two cases

“…Moreover, there is a greater occurrence of uterine and tubal anomalies with greater maternal ages. The uterine pathologies include endometrial polyps and uterine fibroids whose occurrence is greater with advancing maternal age [14]. Fibroids, especially those with a sub mucosal or intramural component are associated with low fertility.…”