Uterine fibroids : from observational epidemiology to clinical management

According to this systematic review of epidemiological studies, fibroid prevalence varied widely, with no consistent association across studies between observed estimates and country, methodology, and population. Fibroid incidence was higher in black than in white women independently of other risk factors, suggesting a racial predisposition. A genetic influence was confirmed also by the association with a positive family history. The association with age and menopausal status maybe interpreted in terms of varying degrees of oestrogen exposure, which could explain also the association with food additives and soybean consumption. Along this line, the "anti-oestrogenic" effect of smoking was observed only in women with low BMI. Association were observed also with reproductive factors (parity and time since last birth) and oral/injectable contraceptives.