History of uterine leiomyoma and risk of endometrial cancer in black women

Wise, Lauren A.; Sponholtz, Todd R.; Rosenberg, Lynn; Adams‐Campbell, Lucile L.; Kuohung, Wendy; LaValley, Michael P.; Palmer, Julie R.

doi:10.1007/s10552-016-0728-3

Cited by 12 publications

(18 citation statements)

References 44 publications

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“…This is because up to 50% of women with uterine fibroids have no clinical symptoms [4,7] and the prevalence of uterine fibroids is higher in the general population when pelvic examination and ultrasound are included (reviewed in [6]). Importantly, in Wise's, Fortuny's or Brinton's study [16][17][18], the prevalence of uterine fibroids in controls was 37% in black women, 20% in white women, and 2.2% in Danes (Table 4). The prevalence of uterine fibroids reported in those studies were significantly lower than what other studies reported in the literature, where the estimated cumulative incidence of uterine fibroids by age 50 years was 80% for black women and 70% for white women [4].…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that uterine fibroids shares common pathogenesis, some clinical characteristics and pathological parameters with endometrial cancer. Few studies reported that uterine fibroids increased the risk of developing both endometrial and ovarian cancers [16][17][18][19][20]. However, another study reported that uterine fibroids were not associated with an increased risk of developing endometrial cancer (http://www.…”

Section: Discussionmentioning

confidence: 99%

“…The lack of a control group in some case-control studies could contribute to the controversial findings in the literature. In those case-control studies [16][17][18], a history of uterine fibroids in cases and controls were self-reported in questionnaires, which could result in a recall bias. This is because up to 50% of women with uterine fibroids have no clinical symptoms [4,7] and the prevalence of uterine fibroids is higher in the general population when pelvic examination and ultrasound are included (reviewed in [6]).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, this commonality suggests that there is an association between history of uterine fibroids or endometriosis and the development of endometrial or ovarian cancers. Studies have suggested that uterine fibroids and/or endometriosis increased the risk of developing both endometrial and ovarian cancers [16][17][18][19][20]. However, another study reported that uterine fibroids were not associated with an increased risk of endometrial cancer (http://www.mayoclinic.org/ diseases-conditions/uterine-fibroids/symptoms-caus es/dxc-20212514/).…”

Section: Ivyspringmentioning

confidence: 99%

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Association of benign gynaecological diseases and risk of endometrial and ovarian cancers

Shen¹,

Liu

Lin

et al. 2020

J. Cancer

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Objective: Gynaecologic benign diseases such uterine fibroids share similar pathogeneses with endometrial and ovarian cancers. Whether a history of uterine fibroids increases the risk of developing endometrial or ovarian cancers is controversial, due to uterine fibroids was self-reported in those studies. Methods: In our current case-control study, 268 women with endometrial cancer and 108 women with ovarian cancer were included. In addition, 500 women without gynaecological cancers were randomly selected as a control group. Uterine fibroids in both groups were clinically diagnosed by pelvic examination and ultrasound. Data on age, parity, gravida, stages of cancers and history of uterine fibroids, endometriosis and adenomyosis were collected from hospital database. Results: After adjusted age and parity, the odds of women with history of uterine fibroids or endometriosis were lower in women with endometrial cancer than controls (odds ratio: 0.148, 95% CI: 0.097, 0.225, or 0.360, 95% CI: 0094, 1.381, respectively). The odds of women with a history of uterine fibroids or endometriosis were lower in women with ovarian cancer than controls (odds ratio: 0.141, 95% CI: 0.085, 0.235, or 1.057, 95% CI: 0.377, 2.963, respectively). However, the odds of women with a history of adenomyosis were higher in women with endometrial or ovarian cancers than controls (odd ratio: 3.757, 95% CI: 1.858, 7.599 or 2.341, 95% CI: 1.086, 5.045, respectively). Conclusion: Our observational data suggested that uterine fibroids or endometriosis may be not associated with the increased risk of developing endometrial or ovarian cancer. However, a history of adenomyosis may do.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Ivyspringmentioning

confidence: 99%

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Association of benign gynaecological diseases and risk of endometrial and ovarian cancers

Shen¹,

Liu

Lin

et al. 2020

J. Cancer

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“…In the present study, the total number of women with gynecological diseases was 4537, with 59 (1.30%) diagnosed as EC. To note, the overall incidence rate of women in China is ∼0.063%, which is higher than 0.044% from a previous study on black women in U.S.A. [6]. The 1.30% incidence rate only counts for women with gynecological diseases.…”

Section: Clinical Data Analysis Resultsmentioning

confidence: 63%

Uterine fibroids may play a protecting role against endometrial carcinoma in Chinese women with gynecological diseases

Xia

Dong

et al. 2020

Bioscience Reports

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Abstract Background: It has been reported that uterine fibroids (UFs) may increase the risk of endometrial carcinoma (EC) with the underlying mechanism largely unknown. Here, we explore whether UF could be an influential factor for EC. Methods: We have collected and analyzed clinical data from 4537 Chinese patients to study the co-incidence of UF and EC. Then, a large-scale literature-based data mining was conducted to identify genes implicated as UF downstream regulating targets and EC upstream regulators. In addition, a meta-analysis has been conducted for each of the EC-specific genes, using six independent UF expression datasets. The meta-analysis results, together with literature-based pathway analysis, were used to explore the potential explanation of the clinical data. Results: Our results showed that the incidence rate of EC in the case of UF was 50.53% lower than without UF, which suggested a protective role of UF in EC patients. The meta-analysis identified three significantly overexpressed genes (HTRA3, HOPX, and PCNA) in the case of UF, which were implicated as EC inhibitors in the pathway analysis. Multiple linear regression (MLR) analysis showed that, compared with UF, aging might be a stronger influential factor for EC. Conclusion: Among women with gynecological diseases, UFs may play a protecting role against EC in the Chinese population.

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Estimated Performance of Transvaginal Ultrasonography for Evaluation of Postmenopausal Bleeding in a Simulated Cohort of Black and White Women in the US

et al. 2021

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IMPORTANCEBlack women in the US with endometrial cancer (EC) are more likely to be diagnosed with advanced-stage disease independent of insured status and histologic type. The most common way of diagnosing EC at early stages is through screening of people with postmenopausal bleeding to detect endometrial thickness (ET). This approach may disproportionately underperform in Black women secondary to a higher prevalence of fibroids and nonendometrioid EC in this population, both of which affect the quality of ET measurement.OBJECTIVE To compare the performance of recommended transvaginal ultrasonography (TVUS) ET thresholds as a screening method to prompt endometrial biopsy by race in a simulated cohort of symptomatic women. DESIGN, SETTING, AND PARTICIPANTSIn a simulated retrospective cohort study, based on data from Surveillance, Epidemiology, and End Results (SEER) national cancer registry 2012-2016; the US census; and published estimates of ET distribution and fibroid prevalence, diagnostic test characteristics of the 3-mm or more, 4-mm or more, and 5-mm or more ET thresholds for biopsy to capture EC diagnoses were calculated. The simulated cohort was constructed from February 2, 2020 (date of access to SEER data), to August 31, 2020. Analysis occurred from September 30, 2020, to March 30, 2021, including the primary analysis and the sensitivity calculations. MAIN OUTCOMES AND MEASURESThe main outcome measured was accuracy of the TVUS ET threshold to accurately identify cases of EC, measured by sensitivity, negative predictive value, and area under the curve (AUC).RESULTS A total of 367 073 simulated Black and White women with postmenopausal bleeding were evaluated, including 36 708 with EC. Among Black women, the currently recommended 4-mm or greater ET threshold prompted biopsy for fewer than half of EC cases (sensitivity, 47.5%; 95% CI, 46.0%-49.0%); of women referred for biopsy, 13.1% were EC cases (positive predictive value, 13.1%; 95% CI, 12.5%-13.6%). The AUC for the 4-mm or more threshold was 0.57 (95% CI, 0.56-0.57). In contrast, among the White women, the 4-mm or more threshold led to biopsy for most with EC (sensitivity, 87.9%; 95% CI, 87.6%-88.3%). Of those referred for biopsy, 14.6% had EC (positive predictive value, 14.6%; 95% CI, 14.4%-14.7%); AUC was 0.73 (95% CI, 0.73-0.74). The same variations held for the 3-mm or more and 5-mm or more ET thresholds: sensitivity, positive predictive value, and AUC were consistently lower for Black women than White women. CONCLUSIONS AND RELEVANCEThe findings of this simulated cohort study suggest that use of ET as measured by TVUS to determine the need for EC diagnostic testing in symptomatic women may exacerbate racial disparities in EC stage at diagnosis. In simulated data, TVUS ET screening missed almost 5 times more cases of EC among Black women vs White women owing to the greater prevalence of fibroids and nonendometrioid histologic type in Black women.

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History of uterine leiomyoma and risk of endometrial cancer in black women

Cited by 12 publications

References 44 publications

Association of benign gynaecological diseases and risk of endometrial and ovarian cancers

Association of benign gynaecological diseases and risk of endometrial and ovarian cancers

Uterine fibroids may play a protecting role against endometrial carcinoma in Chinese women with gynecological diseases

Estimated Performance of Transvaginal Ultrasonography for Evaluation of Postmenopausal Bleeding in a Simulated Cohort of Black and White Women in the US

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