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

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

Author information

1
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.
2
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
3
Center for Uterine Fibroids, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
4
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina. Electronic address: baird@niehs.nih.gov.

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

PMID:
24268705
PMCID:
PMC3880401
DOI:
10.1016/j.fertnstert.2013.09.021
[Indexed for MEDLINE]
Free PMC Article
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