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BJOG. 2019 Aug;126(9):1104-1115. doi: 10.1111/1471-0528.15692. Epub 2019 Apr 29.

Influence of race/ethnicity on prevalence and presentation of endometriosis: a systematic review and meta-analysis.

Author information

1
Department of Obstetrics and Gynaecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
2
Department of Obstetrics and Gynecology, St. Luke's Medical Center, Quezon City, Philippines.
3
Health Sciences Library, University of Ottawa, Ottawa, ON, Canada.
4
Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
5
Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada.

Abstract

BACKGROUND:

Understanding the impact of race/ethnicity on the prevalence and presentation of endometriosis may help improve patient care.

OBJECTIVE:

To review systematically the evidence for the influence of race/ethnicity on the prevalence of endometriosis.

SEARCH STRATEGY:

CENTRAL, MEDLINE, PubMed, Embase, LILACS, SCIELO, and CINAHL databases, as well as the grey literature, were searched from date of inception until September 2017.

SELECTION CRITERIA:

Randomised control trials and observational studies reporting on prevalence and/or clinical presentation of endometriosis.

DATA COLLECTION AND ANALYSIS:

Twenty studies were included in the review and 18 studies were used to calculate odds ratio (OR) with 95% confidence interval (CI) through a random effects model. Methodological quality was assessed using the Newcastle-Ottawa risk of bias scale (NOS).

MAIN RESULTS:

Compared with White women, Black woman were less likely to be diagnosed with endometriosis (OR 0.49, 95% CI 0.29-0.83), whereas Asian women were more likely to have this diagnosis (OR 1.63, 95% CI 1.03-2.58). Compared with White women, there was a statistically significant difference in likelihood of endometriosis diagnosis in Hispanic women (OR 0.46, 95% CI 0.14-1.50). Significant heterogeneity (I2  > 50%) was present in the analysis for all racial/ethnic groups but was partially reduced in subgroup analysis by clinical presentation, particularly when endometriosis was diagnosed as self-reported, CONCLUSIONS: Prevalence of endometriosis appears to be influenced by race/ethnicity. Most notably, Black women appear less likely to be diagnosed with endometriosis compared with White women. There is scarce literature exploring the influence of race/ethnicity on symptomatology, as well as treatment access, preference, and response.

TWEETABLE ABSTRACT:

Prevalence of endometriosis may be influenced by race/ethnicity, but there is limited quality literature exploring this topic.

KEYWORDS:

Endometriosis; ethnicity; meta-analysis; race; systematic review

PMID:
30908874
DOI:
10.1111/1471-0528.15692
[Indexed for MEDLINE]

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