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Variation in the incidence of uterine leiomyoma among premenopausal women by age and race.

Abstract

OBJECTIVE

To quantify the incidence of uterine leiomyoma confirmed by hysterectomy, ultrasound, or pelvic examination according to age and race among premenopausal women.

METHODS

From September 1989 through May 1993, 95,061 premenopausal nurses age 25-44 with intact uteri and no history of uterine leiomyoma were followed to determine incidence rates of uterine leiomyoma. The self-reported diagnosis was confirmed in 93% of the medical records obtained for a sample of cases. Using pooled logistic regression, we estimated relative risks (RRs) of uterine leiomyoma according to race and examined whether adjustment for other potential risk factors could explain the variation in the race-specific rates.

RESULTS

During 327,065 woman-years, 4181 new cases of uterine leiomyoma were reported. The incidence rates increased with age, and the age-standardized rates of ultrasound- or hysterectomy-confirmed diagnoses per 1000 woman-years were 8.9 among white women and 30.6 among black women. After further adjustment for marital status, body mass index, age at first birth, years since last birth, history of infertility, age at first oral contraceptive use, and current alcohol consumption, the rates among black women were significantly greater for diagnoses confirmed by ultrasound or hysterectomy (RR 3.25; 95% confidence interval [CI] 2.71, 3.88) and by hysterectomy (RR 1.82; 95% CI 1.17, 2.82) compared with rates among white women. We observed similar RRs when the cohort was restricted to participants who reported undergoing a screening physical examination within the 2 years before baseline.

CONCLUSION

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

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.

    , , , , , ,

    Source

    Obstetrics and gynecology 90:6 1997 Dec pg 967-73

    MeSH

    Adult
    African Americans
    Age Distribution
    Asian Americans
    European Continental Ancestry Group
    Female
    Hispanic Americans
    Humans
    Incidence
    Leiomyoma
    Logistic Models
    Nurses
    Population Surveillance
    Premenopause
    Prospective Studies
    Risk Factors
    United States
    Uterine Neoplasms

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9397113

    Citation

    Marshall, L M., et al. "Variation in the Incidence of Uterine Leiomyoma Among Premenopausal Women By Age and Race." Obstetrics and Gynecology, vol. 90, no. 6, 1997, pp. 967-73.
    Marshall LM, Spiegelman D, Barbieri RL, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997;90(6):967-73.
    Marshall, L. M., Spiegelman, D., Barbieri, R. L., Goldman, M. B., Manson, J. E., Colditz, G. A., ... Hunter, D. J. (1997). Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstetrics and Gynecology, 90(6), pp. 967-73.
    Marshall LM, et al. Variation in the Incidence of Uterine Leiomyoma Among Premenopausal Women By Age and Race. Obstet Gynecol. 1997;90(6):967-73. PubMed PMID: 9397113.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. AU - Marshall,L M, AU - Spiegelman,D, AU - Barbieri,R L, AU - Goldman,M B, AU - Manson,J E, AU - Colditz,G A, AU - Willett,W C, AU - Hunter,D J, PY - 1997/12/16/pubmed PY - 1997/12/16/medline PY - 1997/12/16/entrez SP - 967 EP - 73 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 90 IS - 6 N2 - OBJECTIVE: To quantify the incidence of uterine leiomyoma confirmed by hysterectomy, ultrasound, or pelvic examination according to age and race among premenopausal women. METHODS: From September 1989 through May 1993, 95,061 premenopausal nurses age 25-44 with intact uteri and no history of uterine leiomyoma were followed to determine incidence rates of uterine leiomyoma. The self-reported diagnosis was confirmed in 93% of the medical records obtained for a sample of cases. Using pooled logistic regression, we estimated relative risks (RRs) of uterine leiomyoma according to race and examined whether adjustment for other potential risk factors could explain the variation in the race-specific rates. RESULTS: During 327,065 woman-years, 4181 new cases of uterine leiomyoma were reported. The incidence rates increased with age, and the age-standardized rates of ultrasound- or hysterectomy-confirmed diagnoses per 1000 woman-years were 8.9 among white women and 30.6 among black women. After further adjustment for marital status, body mass index, age at first birth, years since last birth, history of infertility, age at first oral contraceptive use, and current alcohol consumption, the rates among black women were significantly greater for diagnoses confirmed by ultrasound or hysterectomy (RR 3.25; 95% confidence interval [CI] 2.71, 3.88) and by hysterectomy (RR 1.82; 95% CI 1.17, 2.82) compared with rates among white women. We observed similar RRs when the cohort was restricted to participants who reported undergoing a screening physical examination within the 2 years before baseline. CONCLUSION: A higher prevalence of known risk factors did not explain the excess rate of uterine leiomyoma among premenopausal black women. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/9397113/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0029-7844(97)00534-6 DB - PRIME DP - Unbound Medicine ER -