Risk factors for surgically removed fibroids in a large cohort of teachers

Abstract

Objective To describe reproductive and lifestyle correlates of surgically confirmed fibroids. Design Prospective Cohort Study Setting The California Teachers Study (CTS), an ongoing prospective study of over 133,000 female teachers and school administrators identified through the California State Teachers Retirement System. Patients CTS cohort members reporting no prior history of fibroids were ascertained prospectively for surgical diagnosis of fibroids using hospital patient discharge records. Main Outcome Measure(s) Multivariable Cox proportional hazards regression methods were used to assess the association of self-reported menstrual, reproductive, and lifestyle characteristics with fibroids, using ages at the start and end of follow-up (in months) to define time on study. Hazard rate ratios, presented as relative risks (RR) with 95% confidence intervals (CI), were estimated. Results The strongest risk factor we identified was African-American race/ethnicity, as compared to non-Latina white women. We observed a reduced risk of fibroids for postmenopausal women in comparison to premenopausal women, but use of hormone replacement therapies (regardless of formulation) were associated with an increased risk. Other risk factors included race, a family history of fibroids, being overweight and drinking alcohol, Smoking and diabetes were associated with a decreased risk of fibroids. Conclusions These observations provide a more detailed epidemiologic profile of women with surgically managed fibroids

MED12 mutation in patients with hysteromyoma

“…Certain studies have shown that the incidence of hysteromyoma varies among populations of different ethnicities (11)(12)(13)(14)(15)(16). For example, the incidence of hysteromyoma in African females is three times as high as that in Caucasian females (13).…”

“…Also, compared with other ethnicities, African females with hysteromyoma are younger and have larger lesions, with hysteromyomas that grow faster (12,15). The incidence of hysteromyoma in females of African descent is higher than in individuals of other ethnicities, including Hispanic and Asian individuals (11,15,16). Certain studies have indicated that other risks, such as family history, smoking, drinking, hypertension and weight increase, can increase the risk of hysteromyoma, in addition to the risk associated with ethnicity (12,14,16,17).…”

“…The incidence of hysteromyoma in females of African descent is higher than in individuals of other ethnicities, including Hispanic and Asian individuals (11,15,16). Certain studies have indicated that other risks, such as family history, smoking, drinking, hypertension and weight increase, can increase the risk of hysteromyoma, in addition to the risk associated with ethnicity (12,14,16,17). A study by Mäkinen et al (8) indicated that 70% of patients with hysteromyoma in the Finnish population presented with a mutation in the second exon of MED12, which affected the genetically-conserved sequence of the MED12 protein.…”

Study of Environment Lifestyle and Fibroids (SELF): Advancing the Field of Fibroid Epidemiology

“…6,9,10 Until recently, classification of UL in epidemiologic studies relied on self-reported diagnostic history, medical records, or hospital discharge databases. 3,6,9,[11][12][13] Most studies were restricted to cases with a clinical diagnosis or cases presenting for myomectomy or hysterectomy. Such cases generally represent the symptomatic end of the disease spectrum.…”

Variations in the PDCD6 Gene Are Associated with Increased Uterine Leiomyoma Risk in the Chinese

“…For the above reasons, ULs are the most commonly cited indication for hysterectomy (Duhan, 2011). Predisposing factors for UL include environmental and genetic factors, such as early menarche, nullparity, obesity, African-American ethnicity, tamoxifen use (Ross et al, 1986;Samadi et al, 1996;Marshall et al, 1997;Templeman et al, 2009), and polymorphism of the ORC5L, LHFPL3, and PCOLCE genes (Hodge et al, 2009). However, the UL risk associated with programmed cell death 6 (PDCD6) has not been reported.…”