Cervical neoplasia-related factors and decreased prevalence of uterine fibroids among a cohort of African American women - PubMed (original) (raw)

Kristen R Moore et al. Fertil Steril. 2014 Jan.

Abstract

Objective: To investigate whether the previously reported inverse association between cervical neoplasia and uterine fibroids is corroborated.

Design: Cross-sectional analysis of enrollment data from an ongoing prospective study of fibroid development.

Setting: Not applicable.

Patient(s): Self-reported data on abnormal Pap smear, colposcopy, and cervical treatment were obtained from 1,008 African American women ages 23-34 with no previous fibroid diagnosis and no reported history of human papillomavirus vaccination. Presence of fibroids was assessed at a standardized ultrasound examination.

Intervention(s): None.

Main outcome measure(s): The association between the three cervical neoplasia-related variables and the presence of fibroids was evaluated with logistic regression to estimate age-adjusted and multivariable-adjusted odds ratios (aORs).

Result(s): Of the analysis sample, 46%, 29%, and 14% reported a prior abnormal Pap smear, colposcopy, and cervical treatment, respectively. Twenty-five percent had fibroids at ultrasound. Those reporting cervical treatment had a 39% (aOR, 0.61; 95% confidence interval [CI] [0.38-0.96]) reduction in fibroid risk. Weak nonsignificant associations were found for abnormal Pap smear and colposcopy.

Conclusion(s): Although a protective-type association of cervical neoplasia with uterine fibroids seems counterintuitive, a causal pathway is possible, and the findings are consistent with two prior studies. Further investigation is needed on the relationship between fibroids and cervical neoplasia and human papillomavirus-related mechanisms.

Keywords: Uterine fibroids; abnormal Pap smear; cervical neoplasia; cervical treatment; colposcopy.

Published by Elsevier Inc.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: J.S.S has received research grants, served on paid advisory boards, and/or been a paid speaker for GSK, Hologic Gen-Probe, and Merck. K.R.M. has nothing to disclose. D.D.B has nothing to disclose. S.K.L. has nothing to disclose.

Figures

Figure 1

Figure 1

Sensitivity analyses for the association of cervical treatment and uterine fibroids. The figure shows adjusted (for age, age of menarche and parity) odds ratios and 95% CIs. The sample sets are: entire analysis sample (n = 1,008), 1 = participants who reported no difficulty accessing care (n = 662), 2 = participants who reported having a pelvic exam in the past 2 years (n = 803), 3 = participants who reported never smoking (n = 748), 4a = participants who reported their first cervical treatment ≤7 years before enrollment (n=81) and 4b = participants who reported their first cervical treatment >7 years before enrollment (n=65).

References

    1. Stewart EA. Uterine fibroids. Lancet. 2001;357:293–8. - PubMed
    1. Whiteman MK. Inpatient hysterectomy surveillance in the United States, 2000-2004. American Journal of Obstetrics and Gynecology. 2008;198:34–e1–7. - PubMed
    1. Baird D, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. American Journal of Obstetrics and Gynecology. 2003;188:100–7. - PubMed
    1. Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94:435–8. - PubMed
    1. Laughlin SK, Schroeder JC, Baird DD. New directions in the epidemiology of uterine fibroids. Seminars in reproductive medicine. 2010;28:204–17. - PMC - PubMed

MeSH terms

LinkOut - more resources