title: Environmental tobacco smoke and risk of late-diagnosis incident fibroids in the Study of Women's Health across the Nation (SWAN).
abstract: OBJECTIVE
  To assess the longitudinal relationship of environmental tobacco smoke (ETS) exposure during midlife, and its interaction with active smoking, with the risk of late-diagnosis incident uterine fibroids during the menopausal transition.
  
  
  METHODS
  Thirteen-year prospective cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Community-based, multiracial/ethnic cohort of 2,575 women aged 42 to 52 years at baseline, undergoing the menopausal transition.
  
  
  METHODS
  Questionnaire and blood draws.
  
  
  METHODS
  Discrete-time proportional odds models were used to estimate the conditional odds ratio (OR) and 95% confidence interval (CI) of incident fibroids, adjusted for menopausal status, race/ethnicity, study site, age, education, estradiol levels, sex hormone use, body mass index, timing of blood draw, age at menarche, alcohol use, and smoking status and pack-years.
  
  
  RESULTS
  As part of SWAN, at each near-annual study visit, ETS exposure, smoking, and fibroid occurrence were self-reported via questionnaire, and blood draws were collected. Women who were exposed to ETS (≥1 person-hour/week) had 1.28 (95% CI, 1.03, 1.60) times the adjusted odds of incident fibroids in the ensuing year compared the unexposed. The odds were elevated in never smokers (adjusted OR 1.34; 95% CI, 1.06, 1.70) and former smokers (adjusted OR 2.57; 95% CI, 1.05, 7.23).
  
  
  CONCLUSIONS
  In midlife, ETS exposure was associated with an increased risk of late-diagnosis incident fibroids in women undergoing the menopausal transition.
authors.affiliation: Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, and Division of Epidemiology, Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California. Electronic address: jason.wong@nih.gov.
authors.forename: Jason Y Y
authors.initials: JY
authors.lastname: Wong
authors.affiliation: Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, and Division of Epidemiology, Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California.
authors.forename: Po-Yin
authors.initials: PY
authors.lastname: Chang
authors.affiliation: Division of Epidemiology, Department of Public Health Sciences, School of Medicine, University of California-Davis, Davis, California.
authors.forename: Ellen B
authors.initials: EB
authors.lastname: Gold
authors.affiliation: Department of Statistics, University of California-Irvine, Irvine, California.
authors.forename: Wesley O
authors.initials: WO
authors.lastname: Johnson
authors.affiliation: Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, and Division of Epidemiology, Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California; Medical Services, Veteran Affairs, Palo Alto Health Care System, Palo Alto, California.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Lee
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D019570:Inhalation Exposure / Q000009:adverse effects*; D007889:Leiomyoma / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D008137:Longitudinal Studies; D008593:Menopause / Q000097:blood; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D016387:Women's Health
chemical_list: D014028:Tobacco Smoke Pollution; D004958:Estradiol
keywords: Environmental tobacco smoke; leiomyomas; longitudinal study; secondhand smoke; uterine fibroids