Fertility and sterility · 2013
Cervical neoplasia-related factors and decreased prevalence of uterine fibroids among a cohort of African American women.
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Moore Kristen R, Smith Jennifer S, Laughlin-Tommaso Shannon K, Baird Donna D
Аннотация
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.
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.