title: The burden of uterine fibroids in five European countries.
abstract: OBJECTIVE
  To quantify the burden of uterine fibroids (UF) on health-related quality of life (HRQOL) and work productivity in a general population of women.
  
  
  METHODS
  Women diagnosed with or experiencing UF-related symptoms living in five Western European countries (France, Germany, Italy, Spain, and the United Kingdom) were identified through a cross-sectional Internet-based survey. The following parameters and outcomes of interest were captured and analysed: patient history and demographics, treatment and diagnosis patterns, symptom severity and HRQOL, work productivity and activity impairment, and disease or symptom-related health care resource use for the past year (e.g., provider visits, hospitalisation).
  
  
  RESULTS
  This analysis included 1756 women (France, 358; Germany, 345; Italy, 351; Spain, 352; United Kingdom, 350). Prevalence of a diagnosis of UF ranged from 11.7% to 23.6%, and that of undiagnosed bleeding symptoms from 14.7% to 24.6% across the five countries. Between 9.0% and 32.5% of women waited > or =5 years before seeking treatment for UF. Mean UFS-QOL symptom severity scores ranged from 24.7 (95% confidence interval [CI], 21.1-28.3) to 37.6 (95% CI, 32.2-43.0; P<0.001), suggesting mild to moderate severity. Mean UFS-QOL scores ranged from 59.2 (95% CI, 54.2-64.2) to 69.7 (95% CI, 66.5-73.0; P=0.002), suggesting moderate impairment. In pooled analyses, absenteeism was reported by 32.7% of employed women with a diagnosis of UF. Overall worker productivity was reduced by 36.1% and general activity was impaired by 37.9%.
  
  
  CONCLUSIONS
  UF are common in women residing in Western Europe. They are associated with impairment of HRQOL and productivity. A substantial number of women delay seeking medical help. Encouraging symptomatic women to seek help and treatment earlier may benefit women by improving their HRQOL and may also benefit society through enhanced worker productivity.
authors.affiliation: Barnet and Chase Farm Hospitals NHS Trust, The Ridgeway, Enfield EN2 8JL, United Kingdom.
authors.forename: Ellis
authors.initials: E
authors.lastname: Downes
authors.forename: Vanja
authors.initials: V
authors.lastname: Sikirica
authors.forename: Juan
authors.initials: J
authors.lastname: Gilabert-Estelles
authors.forename: Susan C
authors.initials: SC
authors.lastname: Bolge
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Dodd
authors.forename: Christine
authors.initials: C
authors.lastname: Maroulis
authors.forename: Dhinagar
authors.initials: D
authors.lastname: Subramanian
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004526:Efficiency; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy / Q000473:pathology* / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D016896:Treatment Outcome; D047368:Tumor Burden; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000523:psychology*