title: Perceived racial discrimination and risk of uterine leiomyomata.
abstract: BACKGROUND
  The incidence of uterine leiomyomata (fibroids, myomas) is 2-3 times higher in black women than white women. Black women also report higher levels of racial discrimination. We evaluated the hypothesis that greater exposure to racism increases myoma risk in black women.
  
  
  METHODS
  Data were derived from the Black Women's Health Study, a prospective cohort study of US black women age 21-69 years in 1995. In 1997, women reported on "everyday" and "lifetime" experiences of racism. From 1997 through 2003, we followed 22,002 premenopausal women to assess the association between self-reported racism and risk of myomas. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated from Cox regression models.
  
  
  RESULTS
  During 107,127 person-years of follow-up, 3440 new cases of uterine myomas confirmed by ultrasound (n = 2774) or surgery (n = 666) were reported. All IRRs for "lifetime" and "everyday" experiences of racism were above 1.0. Using a summary variable that averaged the responses from 5 "everyday" racism items, multivariable IRRs comparing quartiles 2, 3, and 4 to quintile 1 (lowest) were 1.16 (95% CI = 1.04-1.29), 1.19 (1.06-1.32), and 1.27 (1.14-1.43), respectively. Multivariable IRRs comparing women who reported 1, 2, or 3 lifetime occurrences of major discrimination (ie, job, housing, or police) relative to those who reported none were 1.04 (0.96-1.13), 1.17 (1.07-1.28), and 1.24 (1.10-1.39), respectively. Results did not vary according to case definition (ultrasound vs. surgery) or health care utilization. Associations were weaker among foreign-born women and among women with higher coping skills.
  
  
  CONCLUSIONS
  Perceived racism was associated with an increased risk of uterine myomas in US-born black women.
authors.affiliation: Slone Epidemiology Center, Boston University, Boston, MA 02215, USA. lwise@slone.bu.edu
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Wise
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.forename: Yvette C
authors.initials: YC
authors.lastname: Cozier
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Hunt
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stewart
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D011287:Prejudice; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000209:etiology