Women with Endometriosis and uterine fibroids likely to have Premature death, suggests study

A new study published in the British Medical Journal showed that women who have a history of uterine fibroids and endometriosis may be more likely to die young after they have finished having children. With clinically significant prevalences of 10% and 15% to 30%, respectively, endometriosis and uterine fibroids are prevalent conditions among women in their reproductive years.

Growth of endometrial-like tissue outside the uterus is a hallmark of endometriosis. Uterine fibroids, on the other hand, are smooth muscle cell-based, non-cancerous tumors that usually develop inside or near the myometrium. But uterine fibroids and endometriosis have similar genetic roots, and they grow through a combination of proinflammatory, immunological, and endocrine mechanisms. As a result, Yi-Xin Wang looked at how endometriosis and uterine fibroids affected the long-term risk of premature death in women from the Nurses' Health Study II (NHSII), which has been conducted every two years for 30 years in the United States.

In 1989, 110,091 women between the ages of 25 and 42 who had never had a hysterectomy previously were diagnosed with cancer, cardiovascular disease, or endometriosis or fibroids were included. The key performance indicators Hazard ratios (calculated using Cox proportional hazards models) for overall and cause-specific premature death based on uterine fibroids confirmed by ultrasound or hysterectomy or endometriosis verified by laparoscopy and reported in biennial questionnaires.

Over the course of 2994,354 person years of follow-up, 4356 premature deaths were documented, including 90 from respiratory illnesses, 304 from cardiovascular disorders, and 1459 from cancer. Women with and without laparoscopically diagnosed endometriosis had crude incidences of all-cause premature death of 2.01 and 1.40 per 1000 person years, respectively.

Laparoscopically verified endometriosis was linked to a hazard ratio of 1.19 for premature mortality in age-adjusted models and these models were reinforced after controlling for behavioral variables and other possible confounders. In cause-specific mortality studies, uterine fibroids verified by ultrasound or hysterectomy were linked to a higher chance of dying from a malignant tumor of gynecological organs, but not to all cause premature death.

Women who reported both endometriosis and uterine fibroids had a higher risk of premature mortality from all causes. Overall, women who had a history of endometriosis and uterine fibroids were more likely to die young and die from gynecological malignancies.

Source:

Wang, Y.-X., Farland, L. V., Gaskins, A. J., Wang, S., Terry, K. L., Rexrode, K. M., Rich-Edwards, J. W., Tamimi, R., Chavarro, J. E., & Missmer, S. A. (2024). Endometriosis and uterine fibroids and risk of premature mortality: prospective cohort study. In BMJ (p. e078797). BMJ. https://doi.org/10.1136/bmj-2023-078797