title: Risk factors for surgically removed fibroids in a large cohort of teachers.
abstract: OBJECTIVE
  To describe reproductive and lifestyle correlates of surgically confirmed fibroids.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  The California Teachers Study, an ongoing prospective study of more than 133,000 female teachers and school administrators identified through the California State Teachers Retirement System.
  
  
  METHODS
  California Teachers Study cohort members, reporting no previous history of fibroids, were ascertained prospectively for surgical diagnosis of fibroids using hospital patient discharge records.
  
  
  METHODS
  Multivariable Cox proportional hazards regression methods were used to assess the association of self-reported menstrual, reproductive, and lifestyle characteristics with fibroids, using ages at the start and end of follow-up (in months) to define time on study. Hazard rate ratios, presented as relative risks (RR) with 95% confidence intervals (CI), were estimated.
  
  
  RESULTS
  The strongest risk factor we identified was African-American race/ethnicity, as compared to non-Latina white women. We observed a reduced risk of fibroids for postmenopausal women in comparison to premenopausal women, but use of hormone replacement therapies (regardless of formulation) were associated with an increased risk. Other risk factors included race, a family history of fibroids, being overweight, and drinking alcohol, Smoking and diabetes were associated with a decreased risk of fibroids.
  
  
  CONCLUSIONS
  These observations provide a more detailed epidemiologic profile of women with surgically managed fibroids.
authors.affiliation: Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, California. Electronic address: clairetempleman@earthlink.net.
authors.forename: Claire
authors.initials: C
authors.lastname: Templeman
authors.affiliation: Department of Epidemiology, University of California, Irvine, California.
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Marshall
authors.affiliation: Northern California Cancer Center, Fremont, California.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Clarke
authors.affiliation: Department of Cancer Etiology, Division of Population Science, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Katherine
authors.initials: K
authors.lastname: DeLellis Henderson
authors.affiliation: Department of Epidemiology, University of California, Irvine, California.
authors.forename: Joan
authors.initials: J
authors.lastname: Largent
authors.affiliation: Department of Epidemiology, University of California, Irvine, California.
authors.forename: Susan
authors.initials: S
authors.lastname: Neuhausen
authors.affiliation: Northern California Cancer Center, Fremont, California.
authors.forename: Peggy
authors.initials: P
authors.lastname: Reynolds
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California.
authors.forename: Giske
authors.initials: G
authors.lastname: Ursin
authors.affiliation: Department of Cancer Etiology, Division of Population Science, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005178:Faculty / Q000706:statistics & numerical data; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D015994:Incidence; D007889:Leiomyoma / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D017584:Reproductive History; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery