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Growth of uterine leiomyomata among premenopausal black and white women.

Abstract

Uterine leiomyomata (fibroids) are the leading cause of hysterectomy in the United States. Black women have a greater fibroid burden than whites, yet no study has systematically evaluated the growth of fibroids in blacks and whites. We prospectively tracked growth for 262 fibroids (size range: 1-13 cm in diameter) from 72 premenopausal participants (38 blacks and 34 whites). Fibroid volume was measured by computerized analysis of up to four MRI scans over 12 months. We used mixed effects models to identify factors that are associated with growth, and results were converted to percent change per 6 months for clinical relevance. The median growth rate was 9% (range: -89% to +138%). Seven percent of fibroids regressed (>20% shrinkage). Tumors from the same woman grew at different rates (within-woman component of variation was twice the component among women; both were significant, P < 0.001). Black and white women less than 35 years of age had similar fibroid growth rates. However, growth rates declined with age for whites but not for blacks (P = 0.05). The odds of a tumor growing more than 20% in 6 months also decreased with age for whites but not for blacks (P < 0.01). Growth rates were not influenced by tumor size, location, body mass index, or parity. We conclude that (i) spontaneous regression of fibroids occurs; (ii) fibroids from the same woman grow at different rates, despite a uniform hormonal milieu; (iii) fibroid size does not predict growth rate; and (iv) age-related differences in fibroid growth between blacks and whites may contribute to the higher symptom burden for black women.

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  • Authors+Show Affiliations

    ,

    Biostatistics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.

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    Source

    MeSH

    Adult
    African Americans
    European Continental Ancestry Group
    Female
    Humans
    Incidence
    Leiomyoma
    Longitudinal Studies
    Magnetic Resonance Imaging
    Male
    Middle Aged
    Premenopause
    United States
    Uterine Neoplasms
    Young Adult

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, N.I.H., Intramural

    Language

    eng

    PubMed ID

    19047643

    Citation

    Peddada, Shyamal D., et al. "Growth of Uterine Leiomyomata Among Premenopausal Black and White Women." Proceedings of the National Academy of Sciences of the United States of America, vol. 105, no. 50, 2008, pp. 19887-92.
    Peddada SD, Laughlin SK, Miner K, et al. Growth of uterine leiomyomata among premenopausal black and white women. Proc Natl Acad Sci USA. 2008;105(50):19887-92.
    Peddada, S. D., Laughlin, S. K., Miner, K., Guyon, J. P., Haneke, K., Vahdat, H. L., ... Baird, D. D. (2008). Growth of uterine leiomyomata among premenopausal black and white women. Proceedings of the National Academy of Sciences of the United States of America, 105(50), pp. 19887-92. doi:10.1073/pnas.0808188105.
    Peddada SD, et al. Growth of Uterine Leiomyomata Among Premenopausal Black and White Women. Proc Natl Acad Sci USA. 2008 Dec 16;105(50):19887-92. PubMed PMID: 19047643.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Growth of uterine leiomyomata among premenopausal black and white women. AU - Peddada,Shyamal D, AU - Laughlin,Shannon K, AU - Miner,Kelly, AU - Guyon,Jean-Philippe, AU - Haneke,Karen, AU - Vahdat,Heather L, AU - Semelka,Richard C, AU - Kowalik,Ania, AU - Armao,Diane, AU - Davis,Barbara, AU - Baird,Donna Day, Y1 - 2008/12/01/ PY - 2008/12/3/entrez PY - 2008/12/3/pubmed PY - 2009/1/13/medline SP - 19887 EP - 92 JF - Proceedings of the National Academy of Sciences of the United States of America JO - Proc. Natl. Acad. Sci. U.S.A. VL - 105 IS - 50 N2 - Uterine leiomyomata (fibroids) are the leading cause of hysterectomy in the United States. Black women have a greater fibroid burden than whites, yet no study has systematically evaluated the growth of fibroids in blacks and whites. We prospectively tracked growth for 262 fibroids (size range: 1-13 cm in diameter) from 72 premenopausal participants (38 blacks and 34 whites). Fibroid volume was measured by computerized analysis of up to four MRI scans over 12 months. We used mixed effects models to identify factors that are associated with growth, and results were converted to percent change per 6 months for clinical relevance. The median growth rate was 9% (range: -89% to +138%). Seven percent of fibroids regressed (>20% shrinkage). Tumors from the same woman grew at different rates (within-woman component of variation was twice the component among women; both were significant, P < 0.001). Black and white women less than 35 years of age had similar fibroid growth rates. However, growth rates declined with age for whites but not for blacks (P = 0.05). The odds of a tumor growing more than 20% in 6 months also decreased with age for whites but not for blacks (P < 0.01). Growth rates were not influenced by tumor size, location, body mass index, or parity. We conclude that (i) spontaneous regression of fibroids occurs; (ii) fibroids from the same woman grow at different rates, despite a uniform hormonal milieu; (iii) fibroid size does not predict growth rate; and (iv) age-related differences in fibroid growth between blacks and whites may contribute to the higher symptom burden for black women. SN - 1091-6490 UR - https://www.unboundmedicine.com/medline/citation/19047643/Growth_of_uterine_leiomyomata_among_premenopausal_black_and_white_women_ L2 - http://www.pnas.org/cgi/pmidlookup?view=long&amp;pmid=19047643 DB - PRIME DP - Unbound Medicine ER -