Cervical neoplasia related factors and decreased prevalence of uterine fibroids among a cohort of African American women

Capsule:
As in two previous studies, a measure of cervical neoplasia was associated with a decreased risk of fibroids (patients with a history of cervical treatment had a 39% adjusted reduction in odds).

Authors:
Kristen R. Moore, M.S.P.H., Jennifer S. Smith, Ph.D., M.P.H., Shannon K. Laughlin-Tommaso, M.D., M.P.H., Donna D. Baird, Ph.D., M.P.H.

Volume 101, Issue 1, Pages 208-214, January 2014

Abstract:

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.

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