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

Fertil Steril. 2014 Jan;101(1):208-14. doi: 10.1016/j.fertnstert.2013.09.021. Epub 2013 Oct 23.

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.

Keywords: Uterine fibroids; abnormal Pap smear; cervical neoplasia; cervical treatment; colposcopy.

MeSH terms

  • Adult
  • African Americans / ethnology*
  • Cervical Intraepithelial Neoplasia / diagnosis*
  • Cervical Intraepithelial Neoplasia / ethnology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Leiomyoma / diagnosis*
  • Leiomyoma / ethnology*
  • Prevalence
  • Prospective Studies
  • Young Adult