School of Public Health, The University of Queensland, Herston, QLD, Australia.
Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand.
Hum Reprod. 2024 Sep 1;39(9):2134-2143. doi: 10.1093/humrep/deae162.
What is the estimated prevalence and incidence of uterine fibroids diagnosed in Australian women of reproductive age?
An estimated 7.3% of Australian women had a diagnosis of uterine fibroids by the age of 45-49 years, with age-specific incidence highest in women aged 40-44 years (5.0 cases per 1000 person-years).
Uterine fibroids are associated with a high symptom burden and may affect overall health and quality of life. Studies in different countries show a wide variation in both the prevalence (4.5-68%) and incidence (2.2-37.5 per 1000 person-years) of uterine fibroids, which may be partly explained by the type of investigation, method of case ascertainment, or the age range of the study population, necessitating the reporting of country-specific estimates.
STUDY DESIGN, SIZE, DURATION: This observational prospective cohort study using self-report survey and linked administrative data (2000-2022) included 8066 women, born between 1973 and 1978, in the Australian Longitudinal Study on Women's Health.
PARTICIPANTS/MATERIALS, SETTING, METHODS: A combination of self-report survey and linked administrative health data (hospital, emergency department, the Medicare Benefits Schedule, and the Pharmaceutical Benefits Scheme) were used to identify women with a report of a diagnosis of uterine fibroids between 2000 and 2022.
Of the 8066 Australian women followed for 22 years, an estimated 7.3% of women (95% CI 6.9, 7.6) had a diagnosis of uterine fibroids by the age of 45-49 years. The incidence increased with age and was highest in women aged 40-44 years (5.0 cases per 1000 person-years, 95% CI 4.3, 5.7 cases per 1000 person-years). Women with uterine fibroids were more likely to experience heavy or painful periods. They were also more likely to report low iron levels, endometriosis, and poor self-rated health and to have two or more annual visits to their general practitioner.
LIMITATIONS, REASONS FOR CAUTION: Our estimates are based on self-report of doctor diagnosis or treatment for fibroids and/or data linked to treatment and procedure administrative records. This predominantly captures women with symptomatic fibroids, but has the potential for misclassification of asymptomatic women and an underestimate of overall prevalence and incidence. In addition, questions on fibroids were only asked in surveys when women were 37-42 years of age to 43-48 years of age, so cases at younger ages may have been underestimated (particularly in women with less severe symptoms) as these were only ascertained through data linkage.
These are the first population-based estimates of the prevalence and incidence of uterine fibroids in women of reproductive age in Australia. Establishing these first estimates will help inform health policy and health care provision in the Australian context.
STUDY FUNDING/COMPETING INTEREST(S): The ALSWH is funded by the Australian Government Department of Health and Aged Care. L.FW. was supported by an Australian National Health and Medical Research Council (NHMRC) Centres for Research Excellence grant (APP1153420) and G.D.M. was supported by an NHMRC Leadership Fellowship (APP2009577). The funding bodies played no role in the design, the collection, analysis or interpretation of data, the writing of the manuscript, or the decision to submit the manuscript for publication. There are no competing interests.
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澳大利亚育龄女性中子宫肌瘤的估计患病率和发病率是多少？
在 45-49 岁的澳大利亚女性中，估计有 7.3%的女性被诊断出患有子宫肌瘤，年龄特异性发病率在 40-44 岁的女性中最高（每 1000 人年 5.0 例）。
子宫肌瘤与高症状负担相关，可能会影响整体健康和生活质量。不同国家的研究表明，子宫肌瘤的患病率（4.5-68%）和发病率（每 1000 人年 2.2-37.5 例）差异很大，这可能部分归因于调查类型、病例确定方法或研究人群的年龄范围，因此需要报告特定国家的估计值。
研究设计、大小和持续时间：本观察性前瞻性队列研究使用自我报告调查和链接的行政数据（2000-2022 年），包括澳大利亚妇女健康纵向研究中的 8066 名出生于 1973 年至 1978 年之间的女性。
参与者/材料、设置、方法：结合自我报告调查和链接的行政健康数据（医院、急诊部、医疗保险福利计划和药品福利计划），用于识别 2000 年至 2022 年间报告有子宫肌瘤诊断的女性。
在 8066 名澳大利亚女性随访 22 年中，估计有 7.3%（95%CI 6.9, 7.6）的女性在 45-49 岁时被诊断出患有子宫肌瘤。发病率随年龄增长而增加，在 40-44 岁的女性中最高（每 1000 人年 5.0 例，95%CI 4.3, 5.7 例/1000 人年）。患有子宫肌瘤的女性更有可能出现经量过多或疼痛。她们也更有可能报告低铁水平、子宫内膜异位症和自我评估健康状况较差，并更频繁地每年就诊两次或以上看全科医生。
局限性、谨慎的原因：我们的估计值基于医生诊断或治疗子宫肌瘤的自我报告，以及与治疗和手术行政记录相关的数据。这主要捕获了有症状的子宫肌瘤女性，但存在无症状女性的误诊和总体患病率和发病率低估的可能性。此外，关于子宫肌瘤的问题仅在女性 37-42 岁至 43-48 岁时的调查中提出，因此年龄较小的病例可能被低估（特别是在症状较轻的女性中），因为这些病例仅通过数据链接确定。
这些是澳大利亚育龄女性子宫肌瘤患病率和发病率的首次基于人群的估计值。确定这些首次估计值将有助于为澳大利亚的卫生政策和医疗保健提供信息。
研究资金/利益冲突：ALSWH 由澳大利亚政府卫生部和老年护理部资助。LFW 得到澳大利亚国家健康与医学研究委员会（NHMRC）卓越研究中心赠款（APP1153420）的支持，GDM 得到 NHMRC 领导奖学金（APP2009577）的支持。资金机构在研究设计、数据收集、分析或解释、撰写手稿或决定提交手稿供发表方面没有任何作用。没有利益冲突。
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