Division of Reproductive Endocrinology and Infertility, Departments of Obstetrics and Gynecology and Surgery, Mayo Clinic, Rochester, MN, USA.
Oxford PharmaGenesis, Tubney, Oxford, UK.
BJOG. 2017 Sep;124(10):1501-1512. doi: 10.1111/1471-0528.14640. Epub 2017 May 13.
Uterine fibroids (UFs) are the most common neoplasm affecting women that can cause significant morbidity and may adversely impact fertility.
To examine UF epidemiology and to evaluate the relative strengths of putative risk factors.
MEDLINE and Embase were searched for studies published in English between January 1995 and April 2015.
Publications reporting relevant data from registries and other observational studies with over 1000 patients and single-centre studies with over 100 patients were selected.
Data on UF incidence, prevalence and associated risk factors were extracted from 60 publications.
Wide ranges were reported in both UF incidence (217-3745 cases per 100 000 women-years) and prevalence (4.5-68.6%), depending on study populations and diagnostic methods. Black race was the only factor that was recurrently reported to increase UF risk, by two-threefold compared with white race. Eleven other factors affected UF risk to a magnitude similar to or greater than race. Age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption increased UF risk; use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate, smoking in women with low body mass index and parity reduced UF risk.
We identified 12 risk factors that play an important role in UF epidemiology. The UF risk factor with the strongest evidence is black race. High-quality prospective observational data are needed to improve our understanding of UF epidemiology, and thus its aetiology and optimal management.
Uterine fibroids occur in about 70% of women. Black race and 11 other factors affect uterine fibroid risk.
子宫肌瘤（UFs）是最常见的影响女性的肿瘤，可导致严重的发病率，可能对生育能力产生不利影响。
研究 UF 的流行病学，并评估潜在危险因素的相对强度。
检索 1995 年 1 月至 2015 年 4 月期间以英文发表的 MEDLINE 和 Embase 数据库，以获取相关研究。
选择了报告了来自注册研究和其他观察性研究（超过 1000 例患者）以及单中心研究（超过 100 例患者）的相关数据的出版物。
从 60 篇文献中提取了 UF 发病率、患病率和相关危险因素的数据。
UF 的发病率（每 100000 名妇女年 217-3745 例）和患病率（4.5-68.6%）的报道范围很广，这取决于研究人群和诊断方法。与白种人相比，黑种人是唯一被反复报道会增加 UF 风险的因素，风险增加 2-3 倍。其他 11 个因素也对 UF 风险产生了相似或更大的影响。年龄、绝经前状态、高血压、家族史、上次分娩后时间、食品添加剂和豆浆摄入增加了 UF 风险；口服避孕药或可注射的避孕针醋酸甲羟孕酮的使用、低体重指数和产次的女性吸烟则降低了 UF 风险。
我们确定了 12 个在 UF 流行病学中起重要作用的危险因素。UF 风险因素中证据最充分的是黑种人。需要高质量的前瞻性观察数据来提高我们对 UF 流行病学的认识，从而了解其病因和最佳管理。
子宫肌瘤发生在大约 70%的女性中。黑种人和其他 11 个因素影响子宫肌瘤的风险。
