title: Cervical neoplasia-related factors and decreased prevalence of uterine fibroids among a cohort of African American women.
abstract: OBJECTIVE
  To investigate whether the previously reported inverse association between cervical neoplasia and uterine fibroids is corroborated.
  
  
  METHODS
  Cross-sectional analysis of enrollment data from an ongoing prospective study of fibroid development.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Self-reported data on abnormal Pap smear, colposcopy, and cervical treatment were obtained from 1,008 African American women ages 23-34 with no previous fibroid diagnosis and no reported history of human papillomavirus vaccination. Presence of fibroids was assessed at a standardized ultrasound examination.
  
  
  METHODS
  None.
  
  
  METHODS
  The association between the three cervical neoplasia-related variables and the presence of fibroids was evaluated with logistic regression to estimate age-adjusted and multivariable-adjusted odds ratios (aORs).
  
  
  RESULTS
  Of the analysis sample, 46%, 29%, and 14% reported a prior abnormal Pap smear, colposcopy, and cervical treatment, respectively. Twenty-five percent had fibroids at ultrasound. Those reporting cervical treatment had a 39% (aOR, 0.61; 95% confidence interval [CI] [0.38-0.96]) reduction in fibroid risk. Weak nonsignificant associations were found for abnormal Pap smear and colposcopy.
  
  
  CONCLUSIONS
  Although a protective-type association of cervical neoplasia with uterine fibroids seems counterintuitive, a causal pathway is possible, and the findings are consistent with two prior studies. Further investigation is needed on the relationship between fibroids and cervical neoplasia and human papillomavirus-related mechanisms.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Moore
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.affiliation: Center for Uterine Fibroids, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Shannon K
authors.initials: SK
authors.lastname: Laughlin-Tommaso
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina. Electronic address: baird@niehs.nih.gov.
authors.forename: Donna D
authors.initials: DD
authors.lastname: Baird
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000208:ethnology*; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000208:ethnology*
keywords: Uterine fibroids; abnormal Pap smear; cervical neoplasia; cervical treatment; colposcopy