Donna D Baird1, Stacy A Patchel2, Tina M Saldana3, David M Umbach4, Tracy Cooper5, Ganesa Wegienka5, Quaker E Harmon6. 1. Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Electronic address: baird@niehs.nih.gov. 2. Westat, Durham, NC. 3. Social and Scientific Systems, Durham, NC. 4. Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. 5. Henry Ford Health System, Detroit, MI. 6. Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
Abstract
BACKGROUND: Uterine fibroids are common. Symptoms are debilitating for many, leading to high medical and societal costs. Indirect data suggest that compared with white women, African Americans develop fibroids at least 10 years earlier on average, and their higher health burden has been well documented. OBJECTIVE: The objective of the study was to directly measure fibroid incidence and growth in a large, community-based cohort of young African-American women. STUDY DESIGN: This observational, community-based, prospective study enrolled 1693 African-American women, aged 23-35 years with no prior diagnosis of fibroids. Standardized transvaginal ultrasound examinations at enrollment and after approximately 18 months were conducted to identify and measure fibroids ≥0.5 cm in diameter. Fibroid growth (change in natural log volume per 18 months) was analyzed with mixed-model regression (n = 344 fibroids from 251 women whose baseline ultrasound revealed already existing fibroids). RESULTS: Among the 1123 fibroid-free women with follow-up data (88% were followed up), incidence was 9.4% (95% confidence interval, 7.7-11.2) and increased with age (Ptrend < .0001), from 6% (confidence interval, 3-9) for 23-25 year olds to 13% (confidence interval, 9-17) for 32-35 year olds. The chance of any new fibroid development was greater than twice as high for women with existing fibroids compared with women who were fibroid free at baseline (age-adjusted relative risk = 2.3 (confidence interval, 1.7-3.0). The uterine position of most incident fibroids (60%) was intramural corpus. Average fibroid growth was 89% per 18 months (confidence interval, 74-104%) but varied by baseline fibroid size (P < .0001). Fibroids ≥2 cm in diameter had average growth rates well under 100%. In contrast, small fibroids (<1 cm diameter) had an average growth rate of nearly 200% (188%, confidence interval, 145-238%). However, these small fibroids also had a high estimated rate of disappearance (23%). CONCLUSION: This is the first study to directly measure age-specific fibroid incidence with a standardized ultrasound protocol and to measure fibroid growth in a large community-based sample. Findings indicate that very small fibroids are very dynamic in their growth, with rapid growth, but a high chance of loss. Larger fibroids grow more slowly. For example, a 2-cm fibroid is likely to take 4-5 years to double its diameter. Detailed data on fibroid incidence confirm an early onset in African-American women. Published by Elsevier Inc.
BACKGROUND: Uterine fibroids are common. Symptoms are debilitating for many, leading to high medical and societal costs. Indirect data suggest that compared with white women, African Americans develop fibroids at least 10 years earlier on average, and their higher health burden has been well documented. OBJECTIVE: The objective of the study was to directly measure fibroid incidence and growth in a large, community-based cohort of young African-American women. STUDY DESIGN: This observational, community-based, prospective study enrolled 1693 African-American women, aged 23-35 years with no prior diagnosis of fibroids. Standardized transvaginal ultrasound examinations at enrollment and after approximately 18 months were conducted to identify and measure fibroids ≥0.5 cm in diameter. Fibroid growth (change in natural log volume per 18 months) was analyzed with mixed-model regression (n = 344 fibroids from 251 women whose baseline ultrasound revealed already existing fibroids). RESULTS: Among the 1123 fibroid-free women with follow-up data (88% were followed up), incidence was 9.4% (95% confidence interval, 7.7-11.2) and increased with age (Ptrend < .0001), from 6% (confidence interval, 3-9) for 23-25 year olds to 13% (confidence interval, 9-17) for 32-35 year olds. The chance of any new fibroid development was greater than twice as high for women with existing fibroids compared with women who were fibroid free at baseline (age-adjusted relative risk = 2.3 (confidence interval, 1.7-3.0). The uterine position of most incident fibroids (60%) was intramural corpus. Average fibroid growth was 89% per 18 months (confidence interval, 74-104%) but varied by baseline fibroid size (P < .0001). Fibroids ≥2 cm in diameter had average growth rates well under 100%. In contrast, small fibroids (<1 cm diameter) had an average growth rate of nearly 200% (188%, confidence interval, 145-238%). However, these small fibroids also had a high estimated rate of disappearance (23%). CONCLUSION: This is the first study to directly measure age-specific fibroid incidence with a standardized ultrasound protocol and to measure fibroid growth in a large community-based sample. Findings indicate that very small fibroids are very dynamic in their growth, with rapid growth, but a high chance of loss. Larger fibroids grow more slowly. For example, a 2-cm fibroid is likely to take 4-5 years to double its diameter. Detailed data on fibroid incidence confirm an early onset in African-American women. Published by Elsevier Inc.
Authors: Kara A Michels; Digna R Velez Edwards; Donna D Baird; David A Savitz; Katherine E Hartmann Journal: Ann Epidemiol Date: 2013-11-12 Impact factor: 3.797
Authors: Deborah J DeWaay; Craig H Syrop; Ingrid E Nygaard; William A Davis; Bradley J Van Voorhis Journal: Obstet Gynecol Date: 2002-07 Impact factor: 7.661
Authors: Shyamal D Peddada; Shannon K Laughlin; Kelly Miner; Jean-Philippe Guyon; Karen Haneke; Heather L Vahdat; Richard C Semelka; Ania Kowalik; Diane Armao; Barbara Davis; Donna Day Baird Journal: Proc Natl Acad Sci U S A Date: 2008-12-01 Impact factor: 11.205
Authors: Eric D Levens; Robert Wesley; Ahalya Premkumar; Wendy Blocker; Lynnette K Nieman Journal: Am J Obstet Gynecol Date: 2009-03-09 Impact factor: 8.661
Authors: Kara A Michels; Katherine E Hartmann; Kristin R Archer; Fei Ye; Digna R Velez Edwards Journal: Paediatr Perinat Epidemiol Date: 2015-11-03 Impact factor: 3.980
Authors: Heba M Eltoukhi; Monica N Modi; Meredith Weston; Alicia Y Armstrong; Elizabeth A Stewart Journal: Am J Obstet Gynecol Date: 2013-08-11 Impact factor: 8.661
Authors: Shannon K Laughlin; Donna D Baird; David A Savitz; Amy H Herring; Katherine E Hartmann Journal: Obstet Gynecol Date: 2009-03 Impact factor: 7.623
Authors: Quaker E Harmon; Stacy A Patchel; Shanshan Zhao; David M Umbach; Tracy E Cooper; Donna D Baird Journal: Obstet Gynecol Date: 2022-04-05 Impact factor: 7.623
Authors: Amelia K Wesselink; Jennifer Weuve; Victoria Fruh; Traci N Bethea; Birgit Claus Henn; Quaker E Harmon; Russ Hauser; Paige L Williams; Antonia M Calafat; Michael McClean; Donna D Baird; Lauren A Wise Journal: Fertil Steril Date: 2021-08-05 Impact factor: 7.329
Authors: Alla S Koltsova; Olga A Efimova; Olga V Malysheva; Natalia S Osinovskaya; Thomas Liehr; Ahmed Al-Rikabi; Natalia Yu Shved; Iskender Yu Sultanov; Olga G Chiryaeva; Maria I Yarmolinskaya; Nikolai I Polenov; Vladislava V Kunitsa; Maka I Kakhiani; Tatyana G Tral; Gulrukhsor Kh Tolibova; Olesya N Bespalova; Igor Yu Kogan; Andrey S Glotov; Vladislav S Baranov; Anna A Pendina Journal: Biomedicines Date: 2021-11-26