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Contemporary treatment utilization among women diagnosed with symptomatic uterine fibroids in the United States. Despite the morbidity and high medical costs associated with fibroids, there has been little epidemiologic study of this condition. The most common presenting symptom is heavy menstrual bleeding, which can lead to anaemia, and fatigue and painful periods.4-9 Other UF symptoms include non‐cyclic pain, abdominal protuberance, painful intercourse or pelvic pressure, and bladder or bowel dysfunction resulting in urinary incontinence or retention, pain or constipation.4-10 UFs may also be associated with reproductive problems, including impaired fertility, pregnancy complications and loss, and adverse obstetric outcomes.11-18 UFs are one of the leading causes of hospitalisations for gynaecological disorders, and are the most frequent reason for hysterectomy in the USA.19-24, Uterine fibroids are the most common neoplasm affecting women, and it has been postulated that they occur in over 70% of women by the onset of menopause.25-27 They are estimated to be clinically apparent in 25% of women of reproductive age and cause symptoms severe enough in approximately 25% of women with UFs to require treatment.4, 28, 29 The frequency of the condition is, however, likely to be underestimated because in many women it is asymptomatic, or symptoms develop insidiously, and therefore remains undiagnosed.30, 31 The unknown extent and impact of undetected UFs bias the epidemiological data and evidence on associated factors to reflect severe disease.32. BJOG. 2015 Feb;37(2):157-178. doi: 10.1016/S1701-2163(15)30338-8. Age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption increased UF risk; use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate, smoking in women with low body mass index and parity reduced UF risk. Steroid hormones and hormone antagonists regulate the neural marker neurotrimin in uterine leiomyoma. Developing risk models for multicenter data using standard logistic regression produced suboptimal predictions: A simulation study. Oral contraceptive use was also found to reduce the risk of developing UFs. However, a large proportion of fibroids remain undiagnosed since most are asymptomatic. Uterine-Artery Embolization or Myomectomy for Uterine Fibroids. This higher incidence is, however, likely to be an overestimate reflecting the lack of diagnostic specificity of pelvic examination. To examine UF epidemiology and to evaluate the relative strengths of putative risk factors. hospitalised or community‐based); age of overall population, age of UF population; race; how cases were confirmed; prevalence of UFs; incidence of UFs; risk factors for UFs reported as relative risks (RRs), odds ratios (ORs) or incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Bayer AG provided funding for medical writing services to Oxford PharmaGenesis. For each study, we extracted data on: study period; study type (e.g. Data collection and analysis: The prevalence of UFs varied widely across the studies, from 4.5% to 68.6% (Figure 2).9, 73 Study population characteristics such as country/region and health status (healthy women or those requiring gynaecological care), factors relating to study methodology, including the type of investigation (registry, single‐centre or ‘other observational’ study), and follow‐up time did not consistently influence the prevalence data recorded. T2 - From menarche to menopause. EAS, CC, RAG and RSR were involved in revising the manuscript for important intellectual content and approving the final version for publication. HHS The quality of the epidemiological data varies widely between the studies reviewed, however. Given the hormonal dependence of fibroids, most earlier studies focused on reproductive or hormonal factors. Most studies on UF epidemiology published before the mid‐1990s were based on diagnosis by pathological examination of surgical specimens.30 These older data therefore represent a population of highly selected patients who required hysterectomy, who may constitute only 10–30% of women with ultrasound evidence of UFs.43, 44 The development and widespread use of ultrasonography for UF detection since the mid‐1990s has expanded the epidemiological data on UFs to represent a wider population. Benign metastasizing uterine leiomyoma with lung metastasis: problems of diagnosis and treatment. Racial differences in severity, symptoms and age at diagnosis, The Maine Women's Health Study: II. Clipboard, Search History, and several other advanced features are temporarily unavailable. Herein, we review the epidemiology of UL from published studies to date. In over half the studies (58%; 35/60), participants were self‐selected (e.g. Data on UF incidence, prevalence and associated risk factors were extracted from 60 publications. Millien C, Manzi A, Katz AM, Gilbert H, Smith Fawzi MC, Farmer PE, Mukherjee J. Int J Equity Health. Black race was the only factor that was recurrently reported to increase UF risk, by two–threefold compared with white race. Nonetheless, uterine fibroids remain a common health burden, with a prevalence of nearly 10%. Characteristics associated with prolonged length of stay after myomectomy for uterine fibroids. 2017 Apr 11;17(1):28. doi: 10.1186/s12905-017-0386-y. Objectives: Four women, for women: Caribbean diaspora artists reimag(in)ing the fine art canon. Study quality and reporting quality were good in most (80%; 48/60) of the included publications, defined as fulfilling 19 or more of the 22 statements on the STROBE checklist (Table S3).45 This included all the registry studies and six of the seven ‘other observational’ studies, but less than one third (31%; 5/16) of the single‐centre studies. Epidemiology and management of uterine fibroids. EAS, CC, RAG and RSR contributed to the design of the study, and the analysis and interpretation of the data. BMC Womens Health. NIH There was a large variation in the data on UF prevalence, ranging from 4.5% to 68.6% (Figure 2),9 and no consistent associations between prevalence and country/region, study methodology or population were seen across the studies. women undergoing investigations for possible UF symptoms). international or local populations with different racial compositions, women undergoing screening or treatment, or survey respondents), diagnostic methods used (e.g. Blastocyst formation rate for Asians versus Caucasians and within body mass index categories. Immunological and clinical risk factors differ between recurrent implantation failure and recurrent miscarriage. Comparing Perioperative Outcomes of Uterine Artery Embolization and Hysterectomy in Insurer and Demographically Diverse Populations: A Retrospective, Multi-Center Database Study. Complementary Therapies in Clinical Practice. Two coordination polymers: selective detection of TNP and treatment activity on uterine fibroids combined with ultrasound treatment via inducing cancer cell apoptosis. 3'RNA Sequencing Accurately Classifies Formalin-Fixed Paraffin-Embedded Uterine Leiomyomas. Long term effects of a first pregnancy on the hormonal environment: estrogens and androgens, Immunohistochemical analysis of oestrogen receptors, progesterone receptors and Ki‐67 in leiomyoma and myometrium during the menstrual cycle and pregnancy. In addition to studying the latest in diagnosis and treatment, Mayo Clinic doctors are conducting research in the epidemiology, economics and genetics of fibroids, as well as trying to develop prevention strategies. International Journal of Gynecology & Obstetrics. Reduction of myometrial exposure to unopposed estrogen activity by exogenous progestogens may diminish estrogen‐mediated stimulation of UFs.26, 77, 78 This result may, however, represent a selection bias, because UFs and other confounding indications, such as polycystic ovary syndrome, have historically been relative contraindications for steroidal contraceptives.78, 94, Finally, hypertension, food additive and soybean milk consumption were identified to increase UF risk in single‐centre studies.80, 81. Myomatous erythrocytosis syndrome: A case series, www.calteachersstudy.org/WebsiteGraphs.html#IDX2, In women with low BMI, current smoker vs never. International Journal of Molecular Sciences. Office-based Approach to Evaluation and Management of Abnormal Uterine Bleeding. Evaluation and Management of Abnormal Uterine Bleeding. Number of times cited according to CrossRef: Treatment of symptomatic fibroid disease using uterine fibroid embolisation: An Australian perspective. CC conducted the database searches and extracted the data; CC and RAG drafted the manuscript. Yonsei Med J. Development and Validation of Hormonal Impact of a Mouse Xenograft Model for Human Uterine Leiomyoma. Age is a significant risk factor for the development of fibroids. Risk factors, both modifiable and non-modifiable, are associated with the development of fibroids. Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Detection bias may have been introduced by the use of different methods for UF diagnosis: the less specific method of pelvic examination was used in 20% (12/60) of studies, and more reliable methods including ultrasonography, surgical pathology or magnetic resonance imaging were used in 66% (40/60) of studies (Table S3). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. We assessed the study and reporting quality of each study using the STROBE checklist,45 and also evaluated the risk of recall, selection and detection bias in each study. We identified 12 risk factors that play an important role in UF epidemiology. 2020 Dec 19;12(12):3839. doi: 10.3390/cancers12123839. Risk ratios for developing uterine fibroids (UFs) by: (A) race and ethnicity in four registry studies; BJOG: An International Journal of Obstetrics & Gynaecology, International Journal of Gynecology & Obstetrics, Acta Obstetricia et Gynecologica Scandinavica, Australian and New Zealand Journal of Obstetrics and Gynaecology, Journal of Obstetrics and Gynaecology Research, I have read and accept the Wiley Online Library Terms and Conditions of Use, Smooth muscle, endometrial stromal, and mixed Mullerian tumors of the uterus, Uterine myomas in adolescents: case reports and a review of the literature, Uterine leiomyomata: etiology, symptomatology, and management, Uterine leiomyomas. In an Italian single‐centre study, women who currently used oral contraceptives were less than one‐third as likely to have UFs as those who had never used them (Table 1).78 Similar protective effects but of smaller magnitude were reported in the Nurses’ Health Study II, in which UF risk was 20% lower in all current oral contraceptive users and 53% lower in those with a history of 4–5 years’ oral contraceptive use than in women who had never used them,46 and in a multicentre case–control study in Thailand, in which UF risk was 24% lower in all women who had ever used oral contraceptives than in those who had never used them.77 In addition, women who had used the injectable contraceptive depot medroxyprogesterone acetate (DMPA) were less than half as likely to have UFs than those who had never used it (Table 1).77, Women with hypertension, defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or current use of antihypertensive medication, had an almost fivefold increased risk of UFs compared with those with normal blood pressure in a Japanese single‐centre, case–control study (Table 1).80, In a large case–control survey conducted at a hospital in China, exposure to food additives in processed, sweetened or preserved foods increased the risk of UFs more than threefold compared with no exposure (Table 1).81 The same study found that women who consumed soybean milk had a 2.5‐times greater risk of UFs than those who did not (Table 1).81. 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