Ultrasound-Confirmed, Age-Specific Uterine Leiomyoma Incidence in a Cohort of Black Individuals.
Ultrasound-Confirmed, Age-Specific Uterine Leiomyoma Incidence in a Cohort of Black Individuals.
复制标题
DOI：
10.1097/aog.0000000000004997
复制
发表时间：
2022-12-01
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
--
作者：
评估在环境、生活方式和子宫肌瘤研究(SELF)参与者中经阴道超声确定的子宫肌瘤的特定年龄发病率。SELF是一项纵向队列研究，对象是自认为是黑人的23-35岁的个人。参与者从密歇根州底特律地区招募，在长达10年的时间里接受了最多5次经阴道超声检查，以识别子宫肌瘤。我们随机推算上一次未发现肌瘤的超声日期和首次发现肌瘤的超声日期之间的发病日期。我们使用泊松回归来估计每1000人年的特定年龄发病率，其可信区间(CI)为95%。然后将这些比率与黑人妇女健康研究(BWHS)和护士健康研究II(NHS II)的比率进行比较-这两项前瞻性队列研究基于自我报告的肌瘤诊断。在这个队列中，1693名参与者完成了基线访谈和超声波检查。我们排除了385名(22.7%)在基线期间发现有子宫肌瘤的参与者，7名超声扫描质量较差的参与者，以及60名仅有基线超声扫描的参与者。在其余1241名参与者中，总发病率为每千人年53.9例(95%可信区间48.6，59.6)。年龄别发病率(每千人年发病率)为：30岁(49.7，95%CI 40.9，59.9)；30~34岁(55.2，95%CI 47.0，64.3)；35~39岁(58.2，95%CI 47.3，70.9)。在30岁的参与者中，SELF的发病率是BWHS或NHS II的两倍多。在这项基于超声的前瞻性研究中，年龄特定的子宫肌瘤发病率很高，这表明许多年轻的黑人肌瘤患者没有得到诊断。这些数据表明，当个人出现与肌瘤相容的症状(例如，月经大出血、贫血、盆腔疼痛)时，他们可以从超声筛查中受益。绝经前黑人中的特定年龄肌瘤发病率显著高于先前估计的30岁以下人群中的2倍。
To estimate the age-specific incidence of uterine leiomyomas identified by transvaginal ultrasound among participants in the Study of Environment, Lifestyle and Fibroids (SELF). SELF is a longitudinal cohort study of individuals aged 23–35 years who self-identified as Black. Participants were recruited from the Detroit, Michigan, area and underwent up to five transvaginal ultrasounds over a period of up to 10 years to identify uterine leiomyomas. We randomly imputed incidence dates between the last ultrasound date in which no leiomyomas were detected and the date of the ultrasound in which leiomyomas were first detected. We used Poisson regression to estimate age-specific incidence rates per 1,000 person-years with 95% confidence intervals (CIs). The rates were then compared with those of the Black Women’s Health Study (BWHS) and the Nurses’ Health Study II (NHS II) – two prospective cohort studies based on self-reported leiomyoma diagnoses. In this cohort, 1,693 participants completed a baseline interview and ultrasound. We excluded 385 (22.7%) participants with a leiomyoma detected during baseline, 7 participants whose ultrasound scans were poor quality, and 60 participants with only a baseline ultrasound. Among the remaining 1241 participants, the overall incidence rate was 53.9 cases per 1,000 person-years (95% CI 48.6, 59.6). The age-specific incidence rates (cases per 1,000 person-years) were: <30 years (49.7, 95% CI 40.9, 59.9); 30–34 years (55.2, 95% CI 47.0, 64.3); and 35–39 years (58.2, 95% CI 47.3, 70.9). Among participants age <30 years, the incidence rate in SELF was more than double that of the BWHS or the NHS II. The high age-specific leiomyoma incidence rates in this prospective ultrasound-based study indicate that many young Black individuals with leiomyomas go undiagnosed. These data suggest individuals could benefit from ultrasound screening when they experience symptoms compatible with leiomyomas (e.g., heavy menstrual bleeding, anemia, pelvic pain). Age-specific rates of leiomyomas in pre-menopausal Black individuals significantly exceed prior estimated rates by as much as 2-fold among those under 30 years.