Cancer Causes & Control

, Volume 27, Issue 4, pp 545–552 | Cite as

History of uterine leiomyoma and risk of endometrial cancer in black women

  • Lauren A. Wise
  • Todd R. Sponholtz
  • Lynn Rosenberg
  • Lucile L. Adams-Campbell
  • Wendy Kuohung
  • Michael P. LaValley
  • Julie R. Palmer
Original paper



Previous studies have found an association between uterine leiomyomata (UL) and uterine malignancies. This relation has not been studied in black women, who are disproportionately affected by UL.


We investigated prospectively the association between self-reported physician-diagnosed UL and endometrial cancer in the Black Women’s Health Study. During 1995–2013, 47,267 participants with intact uteri completed biennial health questionnaires. Reports of endometrial cancer were confirmed by pathology data from medical records and cancer registries. Cox regression was used to derive incidence rate ratios (IRR) and 95 % confidence intervals (CI).


There were 300 incident endometrial cancer cases during 689,546 person-years of follow-up. In multivariable models, UL history was associated with a 42 % greater incidence of endometrial cancer compared with no such history (95 % CI 1.12–1.80). IRRs for cancer diagnosed 0–2, 3–9, and ≥10 years after UL diagnosis were 3.20 (95 % CI 2.06–4.98), 0.95 (95 % CI 0.60–1.52), and 1.35 (95 % CI 1.03–1.77), respectively. Stronger overall associations between UL history and endometrial cancer were observed for later stages at cancer diagnosis (IRR = 2.25, 95 % CI 1.09–4.63) and type II/III cancers (IRR = 3.13, 95 % CI 1.64–5.99).


In this large cohort of black women, a history of UL was positively associated with endometrial cancer, particularly type II/III tumors. The strongest association was observed for cancer diagnosed within 2 years of UL diagnosis, a finding that might be explained by greater surveillance of women with UL or misdiagnosis of cancer as UL. However, an association was also observed for cancer reported ≥10 years after UL diagnosis.


African-Americans Uterine leiomyoma Endometrial cancer Prospective studies 



Black Women’s Health Study


Confidence interval


Incidence rate ratio


Uterine leiomyomata



The authors gratefully acknowledge the contributions of BWHS participants & staff. This research was supported by grants R03-CA169888 (PI: Wise), R01-CA058420 (PI: Rosenberg), and UMI-CA164974 (PI: Rosenberg) from the National Cancer Institute, National Institutes of Health. Data on endometrial cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA) and results reported do not necessarily represent their views.

Supplementary material

10552_2016_728_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 kb)


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Lauren A. Wise
    • 1
    • 2
  • Todd R. Sponholtz
    • 1
    • 2
  • Lynn Rosenberg
    • 1
  • Lucile L. Adams-Campbell
    • 3
  • Wendy Kuohung
    • 4
  • Michael P. LaValley
    • 5
  • Julie R. Palmer
    • 1
  1. 1.Slone Epidemiology Center at Boston UniversityBostonUSA
  2. 2.Department of EpidemiologyBoston University School of Public HealthBostonUSA
  3. 3.Lombardi Cancer CenterGeorgetown UniversityWashingtonUSA
  4. 4.Department of Obstetrics and GynecologyBoston University School of MedicineBostonUSA
  5. 5.Department of BiostatisticsBoston University School of Public HealthBostonUSA

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