Department of Obstetrics and Gynaecology, Queen's University, Kingston, Canada.
Department of Obstetrics and Gynaecology, Queen's University, Kingston, Canada; Department of History, Queen's University, Kingston, Canada.
Am J Obstet Gynecol. 2019 Jul;221(1):35.e1-35.e5. doi: 10.1016/j.ajog.2019.01.238. Epub 2019 Feb 6.
Endometriosis is a common gynecologic condition, affecting approximately 10% of reproductive-aged women. It commonly presents with pelvic pain, painful periods, and infertility and can significantly have an impact on one's quality of life. Early exploration into the pathophysiology of this condition identified race as a risk factor for endometriosis, with the condition predominantly identified in white women. It is still unclear whether there is a biological basis for this conviction or whether it can be explained by methodological and social bias that existed in the literature at that time. Although there is more recent literature exploring the association between endometriosis and race/ethnicity, studies have continued to focus on the prevalence of disease and have not taken into account possible variation in disease presentation among women of different ethnicities. Furthermore, information on diverse populations by race/ethnicity, other than white or black, is quite limited. This paper explores the history of how the association between endometriosis and whiteness was established and whether we still ascribe to a certain stereotype of a typical endometriosis patient today. Furthermore, we discuss the potential implications of such a racial bias on patient care and suggest areas of focus to achieve a personalized and patient focused approach in endometriosis care.
子宫内膜异位症是一种常见的妇科疾病，影响大约 10%的育龄妇女。它通常表现为盆腔疼痛、痛经和不孕，并会对生活质量产生重大影响。早期对这种疾病的病理生理学的探索将种族确定为子宫内膜异位症的一个风险因素，这种疾病主要发生在白人妇女中。目前尚不清楚这种信念是否有生物学基础，还是可以用当时文献中存在的方法学和社会偏见来解释。尽管最近有更多的文献探讨了子宫内膜异位症与种族/民族之间的关联，但研究仍集中在疾病的患病率上，而没有考虑不同种族的女性中疾病表现可能存在的差异。此外，关于种族/民族的不同人群（除了白人和黑人）的信息非常有限。本文探讨了子宫内膜异位症与白人之间的关联是如何建立的，以及我们今天是否仍然对典型的子宫内膜异位症患者存在某种刻板印象。此外，我们还讨论了这种种族偏见对患者护理的潜在影响，并提出了一些关注领域，以实现子宫内膜异位症护理的个性化和以患者为中心的方法。
