Does Fibroid Size and Bulk Affect Uterine Fibroid Symptom (UFS) Scores in Asian Compared to Caucasian Women? [13B

Abstract

INTRODUCTION: Uterine fibroids commonly cause pelvic symptoms, abnormal uterine bleeding, and urinary symptoms. According to past UFS data analysis, Asian women report significantly lower symptoms compared to Caucasians. Etiology of this difference has not been studied and may impact early detection and treatment for Asian women. Differences in fibroid burden, clinical risk factors and parity between Asians and Caucasians may correlate to the difference in UFS scores. We examined correlations between race and fibroid symptom severity using MRI and patient clinical data. METHODS: A retrospective cohort study (2013–2016) of Stanford Fibroid Clinic patients identified Caucasians (n=146) and Asians (n=123) with completed UFS surveys and pelvic MRIs. UFS scores and subscores, MRI data, clinical risk factors, and parity were correlated to race. Data were analyzed using Pearson's T-test and Chi squared analysis. RESULTS: Asians had significantly lower BMI values (P=5.31e-09) and were more likely nonsmokers (P=.003) vs Caucasians. Asians were less likely to report pain (P=.010), urinary frequency (P=.032) and urinary stress incontinence (P=.045). There was no significant difference in fibroid burden between groups (P=.618). CONCLUSION: Significant differences in BMI and smoking history may contribute to observed UFS score differences between Asian and Caucasian women, as both have been correlated to increased symptom severity of uterine fibroids in past studies. Conversely, fibroid burden and parity are not associated with the differential symptom experience. Further study of cultural and social factors, and biochemical and inflammatory markers between Asian and Caucasian women with uterine fibroids is necessary to interpret the observed symptom differences.