Variation in the Incidence of Uterine Leiomyoma Among Premenopausal Women by Age and Race

Abstract

A higher prevalence of known risk factors did not explain the excess rate of uterine leiomyoma among premenopausal black women.

Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pro-Saude Study

“…These results are consistent with previous studies in the United States, in which black women were found to have a higher risk of uterine leiomyoma than white women. Marshall et al 6 found a relative risk of uterine leiomyomas Cad. Saúde Pública, Rio de Janeiro, 30(2):305-317, fev, 2014 of 3.3 (95%CI: 2.7-3.9) and of hysterectomy due to uterine leiomyomas of 1.9 (95%CI: 1.2-2.8) among black compared to white women, following adjustments for variables such as age, body mass index (BMI), time elapsed since last pregnancy, history of infertility, alcohol consumption, tobacco use, physical and leisure activity, age at menarche, age at first pregnancy, contraceptive use, and marital status 6 .…”

“…Marshall et al 6 found a relative risk of uterine leiomyomas Cad. Saúde Pública, Rio de Janeiro, 30(2):305-317, fev, 2014 of 3.3 (95%CI: 2.7-3.9) and of hysterectomy due to uterine leiomyomas of 1.9 (95%CI: 1.2-2.8) among black compared to white women, following adjustments for variables such as age, body mass index (BMI), time elapsed since last pregnancy, history of infertility, alcohol consumption, tobacco use, physical and leisure activity, age at menarche, age at first pregnancy, contraceptive use, and marital status 6 . Faerstein et al 5 reported that, compared with white women, black women had more than nine times the odds of uterine leiomyomas (OR = 9.4; 95%CI: 5.7-15.7) after adjustment for age at menarche, use of oral contraceptives, tobacco use, BMI, hypertension, diabetes mellitus, and history of pelvic inflammatory disease.…”

“…In the United States, uterine leiomyomas occur two to nine times more often in black than in white women of all ages, and are associated with more serious symptoms in blacks, who are diagnosed at younger ages and have higher hysterectomy rates than whites 5,6,7,8,9,10,11 . The underlying mechanisms of this color/race inequality remain unknown.…”

“…Established tumor risk factors, for example those tied to reproductive health (e.g. parity, age at first pregnancy, history of infertility, age at menarche, and contraceptive use), seem to explain only a small fraction of the race/ color inequalities 5,6,8 . Alternative hypotheses, not yet explored in depth, point to an increase in polymorphisms and impaired regulation of hormonal receptors involved in the development of uterine leiomyomas 12,13 , as well as vitamin D deficiency 14,15 and psychosocial stress 16,17 , as potential high-impact causes of tumors in black women.…”

Submucous myomas: diagnosis and therapy

“…The first chromosome aberration that was shown to be a specific abnormality was the 1(12;14)(q14-q15; q23-q24) translocation, in 1988 [5]. In the following years numerous publications have reported cytogenetic, molecular and genetic linkage data supporting and accounting for the evidence for genetic predisposition that had been found before, in epidemiological studies, including familial clustering and racial prevalence [6][7][8]. Probably, the most clinically important syndrome known presently for myomas is the autosomal dominant hereditary disease hereditary leiomyomatosis and renal cell carcinoma (HLRCC) [8].…”