Demographic Correlates of Endometriosis Diagnosis Among United States Women Aged 15-50

Patricia GiglioAyers; Ogechukwu Ezike; Christine E Foley; Benjamin P Brown

doi:10.1016/j.jmig.2024.04.020

Demographic Correlates of Endometriosis Diagnosis Among United States Women Aged 15-50

J Minim Invasive Gynecol. 2024 May 1:S1553-4650(24)00200-0. doi: 10.1016/j.jmig.2024.04.020. Online ahead of print.

Authors

Patricia GiglioAyers¹, Ogechukwu Ezike², Christine E Foley², Benjamin P Brown²

Affiliations

¹ Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, Rhode Island (all authors).. Electronic address: pgiglioayers@wihri.org.
² Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, Rhode Island (all authors).

PMID: 38697259
DOI: 10.1016/j.jmig.2024.04.020

Abstract

Objective: To compare demographic characteristics of women with and without a diagnosis of endometriosis.

Design: Data were collected from the National Survey of Family Growth-a publicly available survey designed and administered by the Centers for Disease Control, which uses a nationally-representative sample of the United States population. Univariate data were reported as survey-weighted percentages and means and were analyzed using chi-square, t tests, and logistic regression. Analyses accounted for complex survey design.

Setting: United States.

Participants: Interviews were conducted with 6141 female respondents, aged 15 to 50, between 2017 and 2019.

Interventions: Data were collected through in-person interviews.

Results: Nationally, 5.7% reported a diagnosis of endometriosis (95% CI 4.6-6.9%). Those with endometriosis were older, with a mean age of 39 (95% CI 38.1-39.9), compared to 31.7 (95% CI 31.2-32.2) among those without (p <.0005). Endometriosis diagnosis was significantly associated with race. Compared to non-Hispanic White women, Hispanic women had an adjusted odds ratio (aOR) of 0.37 (95% CI 0.21-0.65) for diagnosis of endometriosis, and non-Hispanic Black women had an aOR of 0.54 (95% CI 0.35-0.84). We also observed a difference in diagnosis by health insurance: compared to those with private insurance or Medi-Gap coverage, those with Medicare or military insurance had an aOR for endometriosis diagnosis of 2.49 (95% CI 1.36-4.55). Finally, compared to those with less than a high school education, those who had completed high school or greater had an aOR for endometriosis diagnosis of 2.84 (95% CI 1.15-6.99).

Conclusion: These disparities in endometriosis diagnosis suggest that intersecting barriers may preclude certain groups from accessing timely endometriosis diagnosis and management. Further studies are warranted to explore these hypothesis-generating data and to identify and address specific barriers to equitable endometriosis diagnosis and management.

Keywords: Demographics; Disparities; Endometriosis; National survey.