Materiały źródłowe

• #1 Epidemiology and management of uterine fibroids – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31960950/

  Uterine leiomyomas are one of the most common and yet understudied diseases in women. […] These tumors, commonly known as fibroids, affect women mainly during their reproductive years and are diagnosed in up to 70% of white women and more than 80% of women of African ancestry during their lifetime. […] This disease has a profound impact on health care delivery and costs worldwide. […] The current options for symptomatic fibroid treatment include expectant, medical, and surgical management, and interventional radiology procedures. […] This article reviews the recent progress and available management strategies for uterine fibroids and highlights areas where further research is needed to find new therapeutic targets and better personalize treatments. […] Epidemiology of uterine fibroids: A systematic review. BJOG. 2017;124:1501-1512.

• #2 Uterine fibroids (leiomyomas): Epidemiology, clinical features, diagnosis, and natural history – UpToDate

  https://www.uptodate.com/contents/uterine-leiomyomas-fibroids-epidemiology-clinical-features-diagnosis-and-natural-history

  Uterine leiomyomas (also referred to as fibroids or myomas) are the most common pelvic neoplasm in females. They arise in reproductive-age females and, when symptomatic, typically present with symptoms of abnormal uterine bleeding and/or pelvic pain/pressure. The epidemiology, diagnosis, and natural history of uterine leiomyomas are reviewed here. […] Uterine fibroids may also have reproductive effects (eg, infertility, adverse pregnancy outcomes).

• #3 Uterine fibroids: Investigation and current management trends

  https://www.racgp.org.au/afp/2016/october/uterine-fibroids-investigation-and-current-managem

  Fibroids are estimated to affect 40-80% of women by age 50 years. […] Symptomatic fibroids are associated with great costs to the patient and the healthcare system; it was estimated that uterine fibroids incurred a total direct cost of US$10.3 billion in the United States in one year alone. […] Fibroids are the most common indication for a hysterectomy. […] One to two in 1000 women with uterine masses are estimated to have a uterine malignancy. […] A history of tamoxifen use for more than five years is associated with a threefold increase in the risk of leiomyosarcoma, and uterine sonographic surveillance is recommended in such cases, especially in patients who have had prior pelvic irradiation. […] Preoperative differentiation between benign fibroids and uterine malignancy is extremely difficult, yet increasingly important because of trends for using conservative and minimally invasive treatments.

• #4 How Common Are Uterine Fibroids? Dr. Lalezarian Explains

  https://www.fibroidspecialists.org/how-common-are-fibroids

  The question of how common are uterine fibroids is a common question from patients. While the exact percentage of the uterine fibroids prevalence is unknown (women living with fibroids), uterine fibroids are an undeniably common condition. Estimates of true prevalence range anywhere from 5% to 21% of all women. […] As dedicated fibroid specialists, we like our patients to have access to the most reliable medical evidence on the topic, so we’ll review a few of the highest-quality studies to help you better understand the epidemiology of uterine fibroids. […] One high-quality cross-sectional survey-based study of almost 22,000 reproductive-age women (age 15 to 49) across 8 countries (USA, UK, Brazil, Canada, France, Germany, Italy, South Korea) found the prevalence of uterine fibroids ranging from 4.5% (UK) to 9.8% (Italy) of women. The prevalence in the US was 6.9%.

• #5 Uterine Fibroid Tumors: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0515/p1503.html

  The incidence of uterine fibroid tumors increases as women grow older, and they may occur in more than 30 percent of women 40 to 60 years of age. Risk factors include nulliparity, obesity, family history, black race, and hypertension. […] Many women develop uterine fibroid tumors (i.e., leiomyomas) as they grow older. In one study, the prevalence of ultrasound-identified tumors ranged from 4 percent in women 20 to 30 years of age to 11 to 18 percent in women 30 to 40 years of age and 33 percent in women 40 to 60 years of age. Studies report that 5.4 to 77 percent of women have uterine fibroid tumors, depending on the population studied and the diagnostic method used. […] Several studies have documented an increased incidence of uterine fibroid tumors in black women. Some evidence also indicates that black women are more likely than white women to have larger and more symptomatic tumors at the time of treatment. […] Recent evidence suggests that women with hypertension have a higher risk of fibroid tumors, possibly through smooth muscle injury or cytokine release.

• #6 Global epidemiological characteristics of uterine fibroids

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10696973/

  The aim of the study was to examine the burden of uterine fibroids at global, regional and national levels in terms of age and the Socio-demographic Index (SDI). […] The global age-standardized incidence rate of uterine fibroids increased from 1990 to 2019, with an EAPC of 0.25 (95% confidence interval (CI): 0.24 to 0.27). In contrast, the global age-standardized DALY rate decreased from 1990 to 2019, with an EAPC of 0.27 (95% CI: 0.31 to 0.23). High and low-middle SDI regions experienced significantly higher age-standardized incidence rates. Moreover, in 2019, low and low-middle SDI regions had significantly higher age-standardized DALY rates due to uterine fibroids than other SDI regions. […] Globally, the age-standardized incidence of uterine fibroids has been increasing in recent years. In contrast, age-standardized DALY rates have exhibited a decreasing trend. Eastern Europe, Tropical Latin America, Brazil and India experience the greatest uterine fibroid burden. Globally, women aged 35-39 years and older have an increased risk of uterine fibroids, as reflected in the higher incidence rates among these age groups.

• #7

  https://www.archivesofmedicalscience.com/Global-epidemiological-characteristics-of-uterine-fibroids,171786,0,2.html

  Global epidemiological characteristics of uterine fibroids […] The aim of the study was to examine the burden of uterine fibroids at global, regional and national levels in terms of age and the Socio-demographic Index (SDI). […] The global age-standardized incidence rate of uterine fibroids increased from 1990 to 2019, with an EAPC of 0.25 (95% confidence interval (CI): 0.24 to 0.27). In contrast, the global age-standardized DALY rate decreased from 1990 to 2019, with an EAPC of 0.27 (95% CI: 0.31 to 0.23). […] Globally, the age-standardized incidence of uterine fibroids has been increasing in recent years. In contrast, age-standardized DALY rates have exhibited a decreasing trend. Eastern Europe, Tropical Latin America, Brazil and India experience the greatest uterine fibroid burden.

• #8 Global, regional, and national time trends in incidence, prevalence, years lived with disability for uterine fibroids, 1990–2019: an age-period-cohort analysis for the global burden of disease 2019 study | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15765-x

  Uterine fibroids are the most common benign neoplasm of the uterus and a major source of morbidity for women. We report an overview of trends in uterine fibroids of incidence rate, prevalence rate, years lived with disability (YLDs) rate in 204 countries and territories over the past 30 years and associations with age, period, and birth cohort. […] Globally, the incident cases, prevalent cases, and the number of YLDs of uterine fibroids increased from 1990 to 2019 with the growth of 67.07%, 78.82% and 77.34%, respectively. […] There were 186 countries and territories that showed an increasing trend in incidence rate, 183 showed an increasing trend in prevalence rate and 174 showed an increasing trend in YLDs rate. […] The global burden of uterine fibroids is becoming more serious in middle SDI, low-middle SDI and low SDI quintiles.

• #9

  https://www.archivesofmedicalscience.com/Global-epidemiological-characteristics-of-uterine-fibroids,171786,0,2.html

  The burden of uterine fibroids varies widely around the world, mainly due to differences in population structure and socioeconomic status. […] From 1990 to 2019, the age-standardized incidence of uterine fibroids increased most significantly in Tropical Latin America and South Asia. […] This study explored the global, regional and national disease burden and age distribution of uterine fibroids from 1990 to 2019, and analyzed the impact of SDI on these characteristics. […] In conclusion, the global age-standardized DALY rates of uterine fibroids decreased from 1990 to 2019. However, the global age-standardized incidence was consistently increasing over the same time period. Worldwide, Tropical Latin America experiences the greatest burden of disease. Globally, women aged 35-39 years or older have a higher incidence of uterine fibroids than younger women.

• #10 Uterine fibroid – Wikipedia

  https://en.wikipedia.org/wiki/Uterine_fibroid

  African American women are two to three times more likely to get fibroids than Caucasian women. […] In African American women fibroids seem to occur at a younger age, grow more quickly, and are more likely to cause symptoms. […] This leads to higher rates of surgery for African Americans, both myomectomy, and hysterectomy. […] Increased risk of fibroids in African Americans causes them to fare worse in in-vitro fertility treatments and raises their risk of premature births and delivery by Caesarean section. […] It is unclear why fibroids are more common in African American women.

• #11 Uterine leiomyoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/uterine-leiomyoma?lang=us

  They are clinically apparent in ~25% of women of reproductive age and over 70% of women by menopause 21. […] Fibroids are responsive to hormones (e.g. stimulated by estrogens). Being rare in prepubertal females, they commonly accelerate in growth during pregnancy and involute with menopause 1. […] 2-3x increased incidence in Black women than in White women 20,21. […] increasing incidence with age: 10x more common between 41-60 years of age compared to 21-30 years of age, reaching a peak at 50-60 years 20,21. […] 3x increased incidence with a family history of uterine fibroids 21.

• #12 Uterine fibroids: current perspectives | IJWH

  https://www.dovepress.com/uterine-fibroids-current-perspectives-peer-reviewed-fulltext-article-IJWH

  Uterine fibroids (also known as leiomyomas or myomas) are the commonest benign uterine tumors, with an estimated incidence of 20%40% in women during their reproductive years. […] A study carried out in the USA with randomly selected women between the ages of 35 and 49 years (who were screened by self-report, medical record, and sonography) showed that the incidence of uterine fibroids by age 35 was 60% among African-American women, increasing to 80% by age 50, whereas Caucasian women showed an incidence of 40% by age 35, and almost 70% by age 50. […] The cumulative incidence (based both on ultrasonographic detection of fibroids in women with an intact uterus and evidence of prior fibroids among women who have had hysterectomies) increases with age, but the rate of increase slows at older ages.

• #13 How Common Are Uterine Fibroids? Dr. Lalezarian Explains

  https://www.fibroidspecialists.org/how-common-are-fibroids

  Another high-quality study randomly selected US women ages 35-49 and screened them for uterine fibroids. The study found that 60% of African-American women had developed uterine fibroids by age 35. By age 50, that figure increased to 80%. Likewise, 40% of caucasian women had developed fibroids by age 35, and almost 70% by age 50. The majority of these women did not report fibroid symptoms. This study has also helped to establish that uterine fibroids are significantly more common in African-American women than in women of other racial profiles. […] While the majority of fibroid cases are asymptomatic and therefore go undetected, uterine fibroids are still extremely common even when we only consider symptomatic cases.

• #14 Uterine fibroids: a narrative review of epidemiology and management, with a focus on uterine artery embolization – Behairy – Gynecology and Pelvic Medicine

  https://gpm.amegroups.org/article/view/10206/html

  UF accounts for a significant degree of health burden across the globe, affecting an estimated 70% of women worldwide, a significant proportion of which is underreported. […] The true extent of disease burden varies considerably between studies, as a majority of studies investigating incidence are based on hospital discharge coding, nationally representative studies, and large prospective cohorts. […] There is disease regression following menopause, although risk factors of obesity and hormone replacement therapy (HRT) have been cited as risk factors for disease in post-menopausal women. […] The most consistently identified risk factors include ethnicity, genetic predisposition, age, hypertension, early menarche, late menopause, polycystic ovarian syndrome (PCOS), and nulliparity. […] UF were found in 60% of black women by 35-49 years of age, and 80% over the age of 50 years.

• #15

  https://journals.lww.com/cmj/fulltext/2024/11050/global_and_regional_trends_in_the_incidence_and.10.aspx

  Current epidemiological research has shown that the prevalence increases with age until menopause and then declines. […] Our analysis demonstrated that the incidence and prevalence of UFs have been increasing globally in the past decade, and there are significant differences among different countries. […] The incidence of UFs showed no significant relationship with the level of national development and was negatively correlated with fertility. […] The increasing trend in the incidence of UFs occurred mostly in Africa, Asia, North America, and South America. […] The incidence of UFs was positively correlated with alcohol intake, hypertension, overweight, and obesity and negatively correlated with smoking.

• #16

  https://crimsonpublishers.com/cjmi/fulltext/CJMI.000613.php

  In a study conducted by Vikhlyaeva et al. [15], with a level of evidence 2, a familial predisposition was reported in uterine fibroids. They show that fibroids are 2.2 times more common when, in the first-degree family, there are women with fibroids (97 families, 97 patients and 118 family members). The risk is 1.94 for sisters and 2.12 for girls. […] Lumbiganon et al. [16] on their population found a positive association between professional life and fibroids, education and fibroids (respectively RR 1.6 (1.21-2.27) and RR 3.46 (2.22-5.41) for patients who have more than 7 years of study.

• #17 Fertility Sparing Management in Uterine Fibroids | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/139270

  Studies have consistently shown a 3-fold increased risk of fibroids among black women compared to white women when controlled for other accepted risk factors. In addition, black women tend to develop uterine fibroids at a younger age, present with larger uteri at the time of diagnosis. They are more likely to suffer from blood-loss anemia compared to white women. This may be related to the fact that black women generally tend to have had earlier menarche compared to white women. […] Other risk factors for fibroids include early menarche, increased interval since last birth, obesity, diet, family history, and hypertension. Notably, one study revealed that women with hypertension have a fivefold increased risk of developing fibroids compared to those without hypertension. […] The risk of fibroids decreases with an increasing number of term pregnancies, such that women having 5 pregnancies have a quarter of the risk of women who had none. The use of hormonal contraceptives and/or depot medroxyprogesterone acetate (DMPA) for any length of time has also been shown to be protective against fibroids.

• #18 Uterine fibroids: a narrative review of epidemiology and management, with a focus on uterine artery embolization – Behairy – Gynecology and Pelvic Medicine

  https://gpm.amegroups.org/article/view/10206/html

  By contrast, UF were found in 40% of white women under the age of 35, and 70% over the age of 50 years. […] Risk increases linearly with increasing weight likely related to aromatase metabolism of adrenal androgens to estrogen. […] UF continues to be the primary indication for hysterectomy, and is the underlying diagnosis in nearly 40% of hysterectomies performed. […] Despite recent developments in alternative drug therapies and minimally invasive options, 27% of hysterectomies are performed for UF disease. […] The aim of this paper is to provide an overview of UF with a more detailed review of uterine artery embolization (UAE) as one of the growing minimally-invasive therapeutic approaches. […] Despite its lower cost, shorter hospital stay, shorter time to return to baseline function and its uterine-preserving quality, studies have demonstrated that UAE utilization is significantly lagging behind surgical approaches with racial disparities being a major driver of its underutilization.

• #19 A COMPREHENSIVE REVIEW OF UTERINE FIBROIDS: PATHOGENESIS, DIAGNOSIS, TREATMENT, AND FUTURE PERSPECTIVES | Journal of Population Therapeutics and Clinical Pharmacology

  https://www.jptcp.com/index.php/jptcp/article/view/3385

  A diet rich in red meat has been connected to a 70% increased risk of fibroids. […] Diagnosis relies on a combination of medical history, physical examination, and imaging studies, such as ultrasound and MRI. […] Surgical interventions, such as hysterectomy, myomectomy, and uterine artery embolization, are available based on the patient’s specific needs and desire for fertility preservation. […] It’s worth noting that large fibroids can impact the uterine cavity’s configuration, potentially affecting embryo implantation and increasing the risk of miscarriage.

• #20 Population-based study of the reproductive risk factors for transvaginal ultrasound diagnosed uterine fibroids in Nigerian women | Scientific Reports

  https://www.nature.com/articles/s41598-023-44703-5

  The history of any type of abortion was associated with reduced risk of UF by about 17% in this study. […] We found a marginal association between regular use of any type of contraception and UF, but this did not persist in multivariable models. […] The risk of UF in our study rose rapidly from early adulthood to about 35 years of age after which it declined slightly, then it resumed a gentler increase in risk. […] Despite our large sample size, population-based enrollment of study participants, and use of TVUS, our study has some limitations. […] In this study, we confirmed many of the associations between UF and reproductive risk factors that have been described in other populations for the first time in a population-based, study of TVUS diagnosed UF in an African population.

• #21 Uterine fibroid – Wikipedia

  https://en.wikipedia.org/wiki/Uterine_fibroid

  About 20% to 80% of women develop fibroids by the age of 50. […] Globally in 2013 it was estimated that 171 million women were affected. […] They are typically found during the middle and later reproductive years. […] After menopause they usually decrease in size. […] Surgery to remove uterine fibroids occurs more frequently in women in „higher social classes”. […] Adolescents develop uterine fibroids much less frequently than older women. […] Up to 50% of people with uterine fibroids have no symptoms. […] The prevalence of uterine fibroids among teenagers is 0.4%. […] The incidence of uterine fibroids in Europe is thought to be lower than the incidence in the US. […] Eighty percent of African American women will develop benign uterine fibroid tumors by their late 40s, according to the National Institute of Environmental Health Sciences.

• #22 Uterine fibroids: current perspectives | IJWH

  https://www.dovepress.com/uterine-fibroids-current-perspectives-peer-reviewed-fulltext-article-IJWH

  The majority of women with uterine fibroids are asymptomatic, and consequently get less clinical attention; fibroid tumors often remain undiagnosed. […] Precise uterine fibroid mapping (localization, measurement, and characterization) is essential for research into clarifying the natural history of these tumors and for evaluating therapeutic responses to investigational agents. […] The optimal selection of patients for medical therapy, noninvasive procedures, or surgery depends on an accurate assessment of the size, number, and position of myomas. […] The diagnosis of fibroids on ultrasound is usually reasonably straightforward though focal adenomyosis can mimic a fibroid and a pedunculated uterine fibroid can sometimes be mistaken for an adnexal mass. […] A recently published Cochrane review has looked at the benefits and risks of UAE versus other medical or surgical interventions for symptomatic uterine fibroids. […] The effect of UAE on ovarian reserve and pregnancy outcome is less well established.

• #23 Risk Factors Associated With Fibroids

  https://www.medscape.com/viewarticle/886395

  Uterine fibroids are common benign tumors of the uterine smooth muscles. Wide ranges of incidence are reported in the literature. […] Because of the frequent diagnosis of uterine fibroids, research addressing their etiology and treatment is important. It is crucial to know their epidemiology and etiologic factors as best as possible. […] A wide incidence range of 845-3745 cases per 100,000 women-years is reported in the literature. The incidence is likely to be affected by the population studied or the method of diagnosis. Similarly to the incidence, prevalence varies significantly among the studies, from 4.5% to 68.6%. The reasons for this wide range are likely to be similar. […] The prevalence and incidence of fibroids are affected by the method of diagnosis. Self-report and pelvic exam are the least specific and are associated with the lowest rates, while imaging studies or surgical findings are likely to result in higher figures due to the identification of small or asymptomatic lesions. […] This study has identified important risk factors; these findings can be used well in clinical and research settings.

• #24 Epidemiology of uterine fibroid in black African women: a systematic scoping review | BMJ Open

  https://bmjopen.bmj.com/content/12/8/e052053

  Epidemiology of uterine fibroid in black African women: a systematic scoping review […] Studies, mainly from high-income countries, suggest that there are ethnic and racial variations in prevalence of uterine fibroids (UF). However, there have been few studies of the epidemiology of UF in sub-Saharan Africa (SSA). We reviewed published articles on the epidemiology of UF in SSA. […] There is lack of robust epidemiological studies of the prevalence, incidence and risk factors of UF in SSA. There is urgent need to study epidemiological and genomics risk factors of UF in SSA because UF is the most common gynaecological neoplasm in this population where it is associated with significant morbidity and occasional, usually perioperative, mortality. […] Our results show that there is limited information on the epidemiology of UF and identified gaps in knowledge of UF among women in SSA despite its high prevalence, morbidity and economic costs. We recommend urgent implementation of well-designed and adequately powered studies to address this gap.

• #25 Uterine Fibroid Information | Texas DSHS

  https://www.dshs.texas.gov/maternal-child-health/uterine-fibroid-information

  In 2021, legislators added uterine fibroid education and research to Health and Safety Code Chapter 100A, It directs the Texas Department of State Health Services (DSHS) to maintain an informational database related to uterine fibroid diagnoses and treatment. […] Fibroids are most common in women in their 30s, 40s, and through menopause. They are more common in Black women than in White, Hispanic, or Asian women. Black women are also more likely than women of other races and ethnicities to experience severe uterine fibroid symptoms. […] If you are interested in researching available data regarding uterine fibroids in Texas, send your request to the DSHS Center for Health Statistics to access a compiled research report and/or an associated research dataset. Email the request(s) to [email protected].

• #26 The Intersection of Nutrition Surveillance and Uterine Fibroids

  https://reachmd.com/news/the-intersection-of-nutrition-surveillance-and-uterine-fibroids/2471180/

  Recent studies highlight the intersection between nutritional data from NHANES and the prevalence of uterine fibroids, emphasizing the impact of heavy metal exposure. […] A recent analysis leveraging NHANES data has uncovered a significant relationship between blood heavy metals and uterine fibroid prevalence among American women. By examining the blood samples of over 4,500 women, research demonstrated a direct correlation between elevated heavy metals like mercury and the occurrence of uterine fibroids. […] Exposure to blood heavy metals, particularly Hg, is significantly associated with an elevated risk of uterine fibroids. […] As the prevalence of uterine fibroids is significant with estimates suggesting that 70-80% of women will develop them by age 50 a multi-faceted strategy incorporating broader assessments is paramount.

• #27

  https://www.ijrcog.org/index.php/ijrcog/article/view/12003

  Uterine fibroids or myomas or leiomyoma of uterus are the most common type of benign tumour of uterus and also most common pelvic tumour in women. […] Objective of the research was to study the epidemiological factors associated with uterine fibroids. […] Incidence of fibroids is most common in 31-40 years of age i.e. 34.9%. […] Prevalence of submucosal fibroids was 38.6%, intramural fibroids 19.3%, submucosal polyp 14.5%, seedling fibroid 13.9% and subserosal fibroid 10.2%.

• #28 Incidence and Health Care Burden of Uterine Fibroids Among Female Service Members in the Active Component of the U.S. Armed Forces, 2011–2022 | Health.mil

  https://health.mil/News/Articles/2024/02/01/MSMR-Uterine-Fibroids?type=All

  Uterine fibroids are the most common benign tumors of the uterus among women in reproductive age, disproportionally affecting non-Hispanic Black women compared to other races and ethnicities. […] Incident uterine fibroids were identified for this report from inpatient and outpatient medical encounter data from 2011 to 2022. Health care burden was estimated utilizing uterine fibroid-related inpatient and outpatient diagnostic and procedure codes. […] A total of 16,046 new uterine fibroid cases were identified, with an incidence rate of 63.5 cases per 10,000 person-years (95% confidence interval: 62.5-64.5). The highest incidence rates were observed among service women 40 years and older, non-Hispanic Black women, and those who served in the Army. […] Uterine fibroid-related medical encounters and individuals affected increased over time from 2011 to 2022, but the number of hospital bed days decreased from 699 days in 2011 to 625 days in 2022. This decrease in bed days could be attributed to the early detection of uterine fibroid cases and increased accessibility of non- or less invasive treatments.

• #29 Etiology of Uterine Fibroids Still Largely a Mystery | SPH

  https://www.bu.edu/sph/news/articles/2016/epidemiology-of-uterine-fibroids-still-largely-a-mystery/

  Preliminary studies examining vitamin D deficiency as a risk factor have yielded consistent positive associations. If confirmed in prospective cohort studies, vitamin D deficiency which is more common among black women than white women could explain a large fraction of the black-white disparity in rates, Wise and Laughlin-Tommaso say. […] Studies should attempt to determine the extent to which patient characteristics, ultrasonographic features and physiological measures are related to fibroid progression from clinical diagnosis (to surgery), they write.

• #30

  https://journals.lww.com/cmj/fulltext/2024/11050/global_and_regional_trends_in_the_incidence_and.10.aspx

  Uterine fibroids (UFs), the most common tumors in women worldwide, may reduce quality of life and daily activities and even lead to adverse fertility and general health events in patients, causing significant societal health and financial burdens. The objective of this study was to evaluate the global burden through epidemiological trends and examine the potential risk factors for UFs at the national level. […] The worldwide incidence and prevalence of UFs have been increasing in the past decade, with AAPCs of 0.27% in the incidence rate and 0.078% in the prevalence rate. During 2010-2019, significant increasing trends in UF ASIR were observed in 52 of 88 countries. […] With the increasing incidence and prevalence worldwide, effective targeted prevention and control of relevant risk factors at the national level should be encouraged to reduce the disease burden of UFs.

• #31 Age of first diagnosis and incidence rate of uterine fibroids in Ghana. A retrospective cohort study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283201

  In Ghana, a report shows that uterine fibroids are common, however, there are limited studies on the incidence of this condition. Uterine fibroids have significant social, economic and, medical implications for the female populace in Ghana. […] Information on the age of first diagnosis and incidence rate of uterine fibroids are extremely crucial in laying out interventions to manage this disorder. […] The annual incidence rates (per 100, 000) showed an increasing pattern as the years progressed.

• #32 Age of first diagnosis and incidence rate of uterine fibroids in Ghana. A retrospective cohort study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283201

  Uterine fibroids are benign tumors that grow in or on the uterus of women. Globally, they occur in more than 80% of women of African ancestry and 70% in white women. Uterine fibroid requires much attention because of its high incidence rate among women of all races and ages. This study sought to document the age of first diagnosis and incidence rates of uterine fibroids in our urban setting. […] The overall average age was 36.298.08 years, with age range 1761 years and the age groups with the highest frequencies were 3539 years (n = 642, 26.00%), 3034 years (n = 563, 22.80%) and 4044 years (n = 381, 15.43%). […] The incidence rate of uterine fibroids increased as the years progressed and it is mostly high in 3539 years age category, with a decreasing annual mean age trend indicative of early diagnosis.

• #33 Uterine fibroids: current perspectives | IJWH

  https://www.dovepress.com/uterine-fibroids-current-perspectives-peer-reviewed-fulltext-article-IJWH

  Most of the older studies (reviewed by Schwartz) had reported an increased risk of fibroids with earlier age of menarche and the newer data confirm these findings. […] Parity has been inversely associated with a risk of fibroid development in the earlier studies, and the newer studies confirm these findings. […] There has been recent evidence suggesting a relationship between alcohol and caffeine intake with a risk of developing fibroids, especially with evidence gathered from the Black Womens Health Study. […] There is contemporary interest in the influence of dynamics encompassing the likes of uterine infection, hormonal, metabolic, dietary, stress, and environmental factors. […] Uterine fibroids are the cause for some of the most common gynecological problems among women presenting to gynecology emergency and outpatient departments in the UK.

• #34 Thieme E-Journals – Seminars in Reproductive Medicine / Abstract

  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0030-1251477

  Although uterine leiomyomata (fibroids) have been the leading indication for hysterectomy in the United States for decades, the epidemiological data on fibroid prevalence and risk factors are limited. […] Our review suggests that metabolic, dietary, stress, and environmental factors may also play a role in fibroid development. […] Epidemiologic contributions to understanding the etiology of uterine leiomyomata. […] Epidemiology of myomas. […] High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. […] Epidemiology of uterine leiomyomata. […] Risk factors for clinically diagnosed uterine fibroids in women around menopause. […] Association of physical activity with development of uterine leiomyoma. […] Relationship between metabolic syndrome and uterine leiomyomas: a case-control study.

• #35 Etiology of Uterine Fibroids Still Largely a Mystery | SPH

  https://www.bu.edu/sph/news/articles/2016/epidemiology-of-uterine-fibroids-still-largely-a-mystery/

  More research is needed into the etiology of uterine fibroids, including studies that clarify the role of estrogen and progesterone and that identify risk factors, according to a literature review led by a School of Public Health researcher. […] According to Wise and Laughlin-Tommaso, studies have found that rates of fibroids tend to increase with age through the reproductive years and decline after menopause. […] Uterine fibroids are the most common diagnosis among inpatient hospitalizations for gynecologic conditions of women in childbearing years, and they disproportionately affect black women. Greater research is needed about why they grow and how to prevent them, says Wise. […] They call for more research into nutritional and psychosocial factors, reproductive tract infections, and environmental toxicants that can mimic the effects of sex steroid hormones or bind to their receptors (e.g. phthalates).

• #36 Uterine Fibroids – The Oncofertility Consortium

  https://oncofertility.msu.edu/non-malignant-conditions/uterine-fibroids/

  Uterine fibroids can lead to infertility in 1-2 percent of women. Proposed mechanisms include interference with implantation, uterine distention, or contractility. […] Therefore, fibroids should be ruled out in any woman presenting with infertility, and removal may become necessary prior to achievement of a pregnancy.

• #37 Molecular and Cellular Insights into the Development of Uterine Fibroids

  https://www.mdpi.com/1422-0067/22/16/8483

  Current data also suggest that each leiomyoma originates from the clonal expansion of a single transformed somatic stem cell of the myometrium. […] Given the relevance of molecular processes in the development of uterine leiomyomas, there is a broad spectrum of molecular tools and resources that could be employed to develop better detection, classification, and treatment methods. […] These promising approaches may help to improve the outcome and quality of life of symptomatologic patients and reduce costs and possible complications. […] Although classification of uLM is based mainly on their localization and histopathological features, efforts are focused on developing a more precise new classification system that may aid diagnostic and therapeutic decision making. […] Molecular classification of uLM has, so far, relied on dividing them into different categories based on their mutational status for the main “driver genes” (MED12, FH, HMGA2), which are usually mutually exclusive.

• #38 Uterine Fibroids: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0115/p100.html

  Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptomatic women. […] Fibroids are rare before puberty, increase in prevalence during the reproductive years, and decrease in size after menopause. […] The major risk factors for fibroid development are increasing age (until menopause) and African descent. Compared with white women, black women have a higher lifetime prevalence of fibroids and more severe symptoms, which can affect their quality of life. […] The evaluation of fibroids is based mainly on the patient’s presenting symptoms: abnormal menstrual bleeding, bulk symptoms, pelvic pain, or findings suggestive of anemia. […] In the United States, ultrasonography is the preferred initial imaging modality for fibroids. […] There are no studies that support surveillance with imaging or repeat imaging in asymptomatic women with fibroids. […] About 3% to 7% of untreated fibroids in premenopausal women regress over six months to three years, and most decrease in size at menopause.

• #39 Uterine fibroids: Investigation and current management trends

  https://www.racgp.org.au/afp/2016/october/uterine-fibroids-investigation-and-current-managem

  A large retrospective trial showed that the risk of unintended morcellation of a uterine leiomyosarcoma following preoperative selection of women with fibroids is one in 4791 women. […] The overall failure rate is estimated to be around 32% within the first two years, compared with 7% of patients after hysterectomy or myomectomy. […] Effects of UAE on premature ovarian failure, overall fertility and pregnancy outcomes are not well established. […] At this stage there is insufficient evidence for pregnancy outcomes after MRI-guided focused ultrasound, and the procedure should be recommended with caution for women who are planning to become pregnant. […] Differential diagnosis of malignancy is important, particularly with ever-increasing conservative modalities.

• #40 Uterine Fibroids | ACOG

  https://www.acog.org/womens-health/faqs/uterine-fibroids

  Many other medications are being studied for the treatment of fibroids. […] Uterine artery embolization (UAE) In this procedure, tiny particles (about the size of grains of sand) are injected into the blood vessels that lead to the uterus. The particles cut off the blood flow to the fibroid and cause it to shrink. UAE can be done as an outpatient procedure in most cases. The effect of UAE on future pregnancies is not clear. […] More research is needed to understand the effect of RFA on future pregnancies.

• #41 Molecular and Cellular Insights into the Development of Uterine Fibroids

  https://www.mdpi.com/1422-0067/22/16/8483

  However, some uLM do not fall within any of these categories, or could belong to more than one category, for example, by presenting both MED12 and HMGA2 alterations. […] These findings show that progesterone and estrogen play a key role in uLM pathogenesis; however, further research on their involvement is needed to explore new therapeutic approaches that exploit the specific mechanisms of action of these ovarian steroid hormones. […] Understanding all the mechanisms behind uLM through the integration of differential cellular/molecular characteristics could facilitate the discovery of tumor-specific biomarkers, as well as the development of a more suitable uLM subclassification system, and therapeutic approaches specifically targeting the affected pathways.

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