Etiological reasons, screening, and simple prophylactic measures of uterine fibroid in women of African descent

Abstract

Uterine fibroids (UF), one of the most common benign gynecologic tumors has been found to occur more often in African women.1 Since the disease is not acute in nature, its onset probably begins early in the reproductive years before clinical manifestation hence the need for early screening and diagnosis. The major reason for such disparities is the fact that routine screening for fibroid is usually not performed as only 20% to 50% of those affected are symptomatic with the rest all being asymptomatic.2 Although interstitial localization of uterine fibroid is the most frequent in practice they become symptomatic only when large in size. However, sub mucous localization appear to be symptomatic irrespective of its size either small or big.3 Although poorly understood, certain etiological factors such as race/ethnicity, parity and age of menarche have been attributed to being the cause of uterine fibroid development in general. In African women however, other factors like obesity, hair relaxer use also come into play thus may explain why the expected pharmacological treatment which have been proven to be effective in other races not be effective in them. The problem is compounded by the fact that many clinical trials do not include adequate representation of all race/ethnicity.4 This leaves the African woman with only surgical treatment options like myomectomy and hysterectomy. Myomectomy is known to have a high recurrence rate while hysterectomy is no better option for the African woman for cultural reasons,5 thus it is imperative to look for other options for treatment for the African woman who may not even be able to afford the emerging pharmacotherapies. To achieve this, there is a need to search for the specific causes of uterine fibroids among the African woman so as to find simple preventive measures to curb this condition thus the purpose of this review.