Abstract
To understand the role of several medical conditions on the risk of uterine fibroids, we analysed the findings of a large case–control study. Cases were 843 women aged 54 or less (median age 43 years, range 21–54) with histologically confirmed uterine fibroids, whose clinical diagnosis dated back no more than 2 years. Indications for surgery were recurrent menorrhagia or ultrasound evidence of fibroids larger than 10 cm in diameter. Controls were 1557 women aged 54 years or less of comparable quinquennia of age (median age 43 years, range 21–54) who had not undergone hysterectomy and were admitted for acute, non-gynecologic, non-hormonal, non-neoplastic conditions to a network of hospitals with a similar catchment area. Clinical history of severe overweight was inversely associated with the risk of fibroids (multivariate odds ratio (OR), OR: 0.6, 95% confidence intervals (CI): 0.5–0.8). An increase in the frequency of fibroids was seen in women with a history of benign breast disease (OR: 1.2, 95% CI: 0.9–1.6) and particularly of breast biopsies (OR: 2.0, 95% CI: 1.2–3.5). The results of this large dataset indicate that medical conditions known or likely to be related to female hormones are not important determinants of the risk of fibroids.
References
Ross RK, Pike MC, Vessey MP, Bull D, Yeates D, Casagrande JT. Risk factors for uterine fibroids: Reduced risk associated with oral contraceptives. Br Med J 1986; 293: 359-362.
Parazzini F, La Vecchia C, Negri E, Cecchetti G, Fedele L. Epidemiologic characteristics of women with uterine fibroids: A case-control study. Obstet Gynecol 1988; 72: 853-857.
Faerstein E, Szklo M, Rosenshein N. Risk factors for uterine leiomyoma: A practice-based case-control study. I. African-American heritage, reproductive history, body size, and smoking. Am J Epidemiol 2001; 153: 1-10.
Parazzini F, Negri E, La Vecchia C, et al. Uterine myomas and smoking. Results from an Italian study. J Reprod Med 1996; 41: 316-320.
Enriori CL, Reforzo-Membrives J. Peripheral aromatization as a risk factor for breast and endometrial cancer in postmenopausal women: A review. Gynecol Oncol 1984; 17: 1-12.
IARC Monographs on the evaluation of carcinogenic risks of humans. 'Hormonal contraception and post-menopausal hormonal therapy', vol. 72. Lyon: IARC, 1999.
Summers WE, Watson RL, Wooldridge WH, Langford HG. Hypertension obesity and fibromyomata uteri, as a syndrome. Arch Intern Med 1971; 128: 750-754.
Faerstein E, Szklo M, Rosenshein NB. Risk factors for uterine leiomyoma: A practice-based case-control study. II. Atherogenic risk factors and potential sources of uterine irritation. Am J Epidemiol 2001; 153: 11-19.
Yu H, Rohan T. Role of insulin-like growth factor family in cancer development and progression. J Natl Cancer Inst 2000; 92: 1472-1489.
Macaulay VM. Insulin-like growth factors and cancer. Br J Cancer 1992; 65: 311-320.
Reaven GM. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-1607.
Mashal RD, Fejzo ML, Friedman AJ, et al. Analysis of androgen receptor DNA reveals the independent clonal origins of uterine leiomyomata and the secondary nature of cytogenetic aberrations in the development of leiomyomata. Genes Chromosomes Cancer 1994; 11: 1-6.
Yam D. Insulin-cancer relationships: Possible dietary implication. Med Hypotheses 1992; 38: 111-117.
Bornfeldt KE, Arnqvist HJ, Capron L. In vivo proliferation of rat vascular smooth muscle in relation to diabetes mellitus, insulin-like growth factor I and insulin. Diabetologia 1992; 35: 104-108.
Chiaffarino F, Parazzini F, La Vecchia C, Chatenoud L, Di Cintio E, Marsico S. Diet and uterine myomas. Obstet Gynecol 1999; 94: 395-398.
Baker RJ, Nelder JA. The GLIM System. Release 3. Oxford: Numerical Algorithms Group, 1978.
Bosetti C, Tavani A, Negri E, Trichopoulos D, La Vecchia C. Reliability of data on medical conditions, menstrual and reproductive history provided by hospital controls. J Clin Epidemiol 2001; 54: 902-906.
Stevenson JC, Crook D, Godsland IF. Influence of age and menopause on serum lipids and lipoproteins in healthy women. Atherosclerosis 1993; 98: 83-90.
Augustin L, Dal Maso L, La Vecchia C, et al. Dietary glycemic index and glycemic load, and breast cancer risk: A case-control study. Ann Oncol 2001; 12: 1533-1538.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Parazzini, F., Chiaffarino, F., Polverino, G. et al. Uterine fibroids risk and history of selected medical conditions linked with female hormones. Eur J Epidemiol 19, 249–253 (2004). https://doi.org/10.1023/B:EJEP.0000020448.43323.2a
Issue Date:
DOI: https://doi.org/10.1023/B:EJEP.0000020448.43323.2a