O&G open · 2025
Association Between Age, Race, Ethnicity, and Body Mass Index and Time to Endometriosis Diagnosis.
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Imbroane Marisa R, Fazeli Yasamin, Kim Hanna, Falcone Tommaso, Richards Elliott G
Аннотация
OBJECTIVE: To assess the associations of time to endometriosis diagnosis after presentation for pelvic pain between patients of different ages, races, ethnicities, and body mass index (BMI) ranges.
METHODS: This retrospective study was conducted with the U.S. Collaborative Network on the TriNetX research network of health care organizations using International Classification of Diseases, Tenth Revision (ICD-10) codes. Race, ethnicity, and BMI cohorts consisted of 18- to 44-year-old female patients with diagnoses of endometriosis (ICD-10 N80) and pelvic-perineal pain (ICD-10 R10.2). Age cohorts consisted of female patients aged 18-30 years or 31-44 years, with the same two diagnoses. The BMI cohorts were categorized as lower than 19.9 (ICD-10 Z68.1), 20-29 (ICD-10 Z68.2), and higher than 30 (ICD-10 Z68.3, Z68.4). Patients were matched for race, ethnicity, and age at pelvic pain diagnosis. We assessed time to endometriosis diagnosis after an initial diagnosis of pelvic and perineal pain using Kaplan-Meier analysis and log-rank test with a value of P<.05 considered significant.
RESULTS: For patients aged 18-30 years (n=13,662), the median time to endometriosis diagnosis was 0.49 years; for patients aged 31-44 years (n=13,662), the median time to diagnosis was 3.10 years (χ2=3,503, P<.001). In a comparison of Black and White patients (n=12,242 patients in each group), the median time to endometriosis diagnosis for Black patients was 1.34 years compared with 0.67 years for White patients (χ2=128, P<.001). For Asian (n=2,453) and White (n=2,453) patients, the median time to endometriosis diagnosis was 0.58 years for Asian patients and 0.64 years for White patients (χ2=0.68, P=.41). For Hispanic and non-Hispanic patients (n=10,640 patients in each group), the median time to endometriosis diagnosis was 1.11 years for Hispanic patients and 0.68 years for non-Hispanic patients (χ2=27, P<.001). For BMI lower than 19.9 (n=1,448) and BMI 20-29 (n=1,448), the median time to endometriosis diagnosis was 1.15 years for BMI lower than 19.9 and 1.35 years for BMI 20-29 (χ2=2.8, P=.10). For BMI higher than 30 (n=1,719) and BMI lower than 19.9 (n=1,719), the median time to endometriosis diagnosis was 1.52 years for BMI higher than 30 compared with 1.15 years for BMI 20-29 (χ2=19.4, P<.001).
CONCLUSION: Disparities exist in the time to endometriosis diagnosis after pelvic and perineal pain diagnosis. Obesity, older age, Black race, and Hispanic ethnicity are associated with longer times from a pelvic pain diagnosis to an endometriosis diagnosis.
METHODS: This retrospective study was conducted with the U.S. Collaborative Network on the TriNetX research network of health care organizations using International Classification of Diseases, Tenth Revision (ICD-10) codes. Race, ethnicity, and BMI cohorts consisted of 18- to 44-year-old female patients with diagnoses of endometriosis (ICD-10 N80) and pelvic-perineal pain (ICD-10 R10.2). Age cohorts consisted of female patients aged 18-30 years or 31-44 years, with the same two diagnoses. The BMI cohorts were categorized as lower than 19.9 (ICD-10 Z68.1), 20-29 (ICD-10 Z68.2), and higher than 30 (ICD-10 Z68.3, Z68.4). Patients were matched for race, ethnicity, and age at pelvic pain diagnosis. We assessed time to endometriosis diagnosis after an initial diagnosis of pelvic and perineal pain using Kaplan-Meier analysis and log-rank test with a value of P<.05 considered significant.
RESULTS: For patients aged 18-30 years (n=13,662), the median time to endometriosis diagnosis was 0.49 years; for patients aged 31-44 years (n=13,662), the median time to diagnosis was 3.10 years (χ2=3,503, P<.001). In a comparison of Black and White patients (n=12,242 patients in each group), the median time to endometriosis diagnosis for Black patients was 1.34 years compared with 0.67 years for White patients (χ2=128, P<.001). For Asian (n=2,453) and White (n=2,453) patients, the median time to endometriosis diagnosis was 0.58 years for Asian patients and 0.64 years for White patients (χ2=0.68, P=.41). For Hispanic and non-Hispanic patients (n=10,640 patients in each group), the median time to endometriosis diagnosis was 1.11 years for Hispanic patients and 0.68 years for non-Hispanic patients (χ2=27, P<.001). For BMI lower than 19.9 (n=1,448) and BMI 20-29 (n=1,448), the median time to endometriosis diagnosis was 1.15 years for BMI lower than 19.9 and 1.35 years for BMI 20-29 (χ2=2.8, P=.10). For BMI higher than 30 (n=1,719) and BMI lower than 19.9 (n=1,719), the median time to endometriosis diagnosis was 1.52 years for BMI higher than 30 compared with 1.15 years for BMI 20-29 (χ2=19.4, P<.001).
CONCLUSION: Disparities exist in the time to endometriosis diagnosis after pelvic and perineal pain diagnosis. Obesity, older age, Black race, and Hispanic ethnicity are associated with longer times from a pelvic pain diagnosis to an endometriosis diagnosis.