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Risk of uterine leiomyomata according to birthplace and geographic region in the black women's health study
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ABSTRACTS (ACE)
AEP Vol. 14, No. 8 September 2004 : 592–624
urologic evaluation): minimal, moderate, or complete (74.6; 75.4); moderate or complete (49.3; 59.7); and complete (29.1; 39.6). Sensitivity (range 67.9–91.1%) and specificity (range 75.8–96.3%) were relatively high and depended on categorization chosen, indicating good agreement between the single ED question and the urologic examination. CONCLUSION: Our single-question self-report of erectile dysfunction compares well with a complete urologic examinationdthe so-called gold standard. Its brevity allows for costefficient and valid information gathering when conducting epidemiologic research. Our single ED question is useful for international comparative studies. It also could be useful in everyday clinical practice. doi:10.1016/j.annepidem.2004.07.081
P083S RISK OF UTERINE LEIOMYOMATA ACCORDING TO BIRTHPLACE AND GEOGRAPHIC REGION IN THE BLACK WOMEN’S HEALTH STUDY LA Wise, JR Palmer, LL Adams-Campbell, L Rosenberg, Slone Epidemiology Center, Boston University, Boston, MA PURPOSE: Uterine leiomyomata (fibroids) are a major source of gynecologic morbidity among U.S. black women. We prospectively examined the incidence of self-reported uterine leiomyomata by birthplace and geographic region in the Black Women’s Health Study, a nationwide follow-up study of U.S. black women. METHODS: From 1997 to 2001, we followed 20,451 premenopausal women with intact uteri and no prior diagnosis of leiomyomata. Cox regression models, stratified by age and time period, were used to derive rate ratios (IRRs) and 95% confidence intervals (CIs) for the associations of interest while adjusting for potential confounders. RESULTS: After 68,580 person-years of follow-up, 2049 ultrasound- or hysterectomy-confirmed cases were reported. Compared with women living in the West, multivariate IRRs for women living in the Northeast, South, and Midwest were 1.20 (95% CI Z 1.05–1.38), 1.24 (95% CI Z 1.09–1.42), and 1.09 (95% CI Z 0.95–1.26), respectively. The multivariate IRR comparing women who were foreign born to U.S. born was 1.21 (95% CI Z 1.01– 1.45). Among the U.S.-born women, risk did not differ according to parents place of birth. CONCLUSION: Our data are the first to provide evidence that incidence of uterine leiomyomata may vary according to birthplace and geographic region in U.S. black women. Control for Pap smear screening and established risk factors for uterine leiomyomata did not account for these findings. doi:10.1016/j.annepidem.2004.07.082
P084S VARIATION IN THE ASSOCIATION OF ALCOHOL INTAKE WITH UTERINE FIBROIDS BY RACE AND TUMOR SIZE AA D’Aloisio, DD Baird, Department of Epidemiology, University of North Carolina, Chapel Hill, NC
PURPOSE: Uterine fibroids are prevalent benign tumors and are the leading indication for hysterectomy in the United States. Hormonal dependence for development and growth of these tumors suggests the role of estrogen-promoting factors. Alcohol intake has been associated with higher concentrations of estrogen among premenopausal women and has been implicated in other hormonally related conditions, including breast cancer. We hypothesized that alcohol intake is associated with an increased risk of uterine fibroids. METHODS: The study population consisted of 1146 premenopausal black or white women from the NIEHS Uterine Fibroid Study. Participants were randomly selected 35- to 49-year-old members of an urban health plan. Assessment of uterine fibroids was performed primarily through transvaginal ultrasounds. Racestratified unconditional logistic regression was used to calculate prevalence odds ratios (OR) and 95% confidence intervals (CI) for the association of uterine fibroids with self-reported current alcohol intake and intake at age 30. Race-stratified polytomous logistic regression was used to assess these relationships with small (0.5 to !2 cm), medium (2–3.99 cm), and large (>4 cm) tumors. Estimates were adjusted for age, vigorous exercise, age at menarche, parity, and body mass index. RESULTS: For white women, the odds of uterine fibroids were 90% greater (95% CI Z 1.0, 3.5) among those currently consuming at least 0.5 alcoholic drinks weekly compared with nondrinkers. The odds ratio with current drinking was strongest for small fibroids (OR Z 4.3; 95% CI Z 1.4, 12.9), and alcohol intake at age 30 was most strongly related to large tumors (OR Z 1.5; 95% CI Z 0.6, 3.7). There was no association of alcohol intake with uterine fibroids for black women (OR Z 1.0; 95% CI Z 0.7, 1.6), but the patterns for current and past drinking with fibroid size were generally similar to those for white women. CONCLUSION: This study suggests the involvement of alcohol intake in the initiation or early growth of uterine fibroids. doi:10.1016/j.annepidem.2004.07.083
P085S ACCURACY OF TIME-TO-PREGNANCY DATA FROM MEN RHN Nguyen, CR Weinberg, DD Baird, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC PURPOSE: Occupational studies of fertility often rely on male report of time-to-pregnancy (TTP). We investigated the accuracy of male report compared with TTP derived from detailed data collected from female partners. METHODS: In a study designed to measure effects of prenatal diethylstilbestrol (DES) on male reproduction, exposed and unexposed men from the Chicago DES cohort were interviewed by phone to assess fertility. The female partner of each male’s most recent pregnancy was interviewed separately. The TTP derived from the female data was used as the gold standard. Kappa (k) statistics were calculated to investigate male factors related to reporting accuracy. RESULTS: Of the 202 couples in which both partners reported a TTP, the male report was identical to the female-derived TTP in 36%, and in 75% it differed by no more than 2 months. Seventeen men had a high-school education or less, and their reporting was
ABSTRACTS (ACE)
AEP Vol. 14, No. 8 September 2004 : 592–624
urologic evaluation): minimal, moderate, or complete (74.6; 75.4); moderate or complete (49.3; 59.7); and complete (29.1; 39.6). Sensitivity (range 67.9–91.1%) and specificity (range 75.8–96.3%) were relatively high and depended on categorization chosen, indicating good agreement between the single ED question and the urologic examination. CONCLUSION: Our single-question self-report of erectile dysfunction compares well with a complete urologic examinationdthe so-called gold standard. Its brevity allows for costefficient and valid information gathering when conducting epidemiologic research. Our single ED question is useful for international comparative studies. It also could be useful in everyday clinical practice. doi:10.1016/j.annepidem.2004.07.081
P083S RISK OF UTERINE LEIOMYOMATA ACCORDING TO BIRTHPLACE AND GEOGRAPHIC REGION IN THE BLACK WOMEN’S HEALTH STUDY LA Wise, JR Palmer, LL Adams-Campbell, L Rosenberg, Slone Epidemiology Center, Boston University, Boston, MA PURPOSE: Uterine leiomyomata (fibroids) are a major source of gynecologic morbidity among U.S. black women. We prospectively examined the incidence of self-reported uterine leiomyomata by birthplace and geographic region in the Black Women’s Health Study, a nationwide follow-up study of U.S. black women. METHODS: From 1997 to 2001, we followed 20,451 premenopausal women with intact uteri and no prior diagnosis of leiomyomata. Cox regression models, stratified by age and time period, were used to derive rate ratios (IRRs) and 95% confidence intervals (CIs) for the associations of interest while adjusting for potential confounders. RESULTS: After 68,580 person-years of follow-up, 2049 ultrasound- or hysterectomy-confirmed cases were reported. Compared with women living in the West, multivariate IRRs for women living in the Northeast, South, and Midwest were 1.20 (95% CI Z 1.05–1.38), 1.24 (95% CI Z 1.09–1.42), and 1.09 (95% CI Z 0.95–1.26), respectively. The multivariate IRR comparing women who were foreign born to U.S. born was 1.21 (95% CI Z 1.01– 1.45). Among the U.S.-born women, risk did not differ according to parents place of birth. CONCLUSION: Our data are the first to provide evidence that incidence of uterine leiomyomata may vary according to birthplace and geographic region in U.S. black women. Control for Pap smear screening and established risk factors for uterine leiomyomata did not account for these findings. doi:10.1016/j.annepidem.2004.07.082
P084S VARIATION IN THE ASSOCIATION OF ALCOHOL INTAKE WITH UTERINE FIBROIDS BY RACE AND TUMOR SIZE AA D’Aloisio, DD Baird, Department of Epidemiology, University of North Carolina, Chapel Hill, NC
PURPOSE: Uterine fibroids are prevalent benign tumors and are the leading indication for hysterectomy in the United States. Hormonal dependence for development and growth of these tumors suggests the role of estrogen-promoting factors. Alcohol intake has been associated with higher concentrations of estrogen among premenopausal women and has been implicated in other hormonally related conditions, including breast cancer. We hypothesized that alcohol intake is associated with an increased risk of uterine fibroids. METHODS: The study population consisted of 1146 premenopausal black or white women from the NIEHS Uterine Fibroid Study. Participants were randomly selected 35- to 49-year-old members of an urban health plan. Assessment of uterine fibroids was performed primarily through transvaginal ultrasounds. Racestratified unconditional logistic regression was used to calculate prevalence odds ratios (OR) and 95% confidence intervals (CI) for the association of uterine fibroids with self-reported current alcohol intake and intake at age 30. Race-stratified polytomous logistic regression was used to assess these relationships with small (0.5 to !2 cm), medium (2–3.99 cm), and large (>4 cm) tumors. Estimates were adjusted for age, vigorous exercise, age at menarche, parity, and body mass index. RESULTS: For white women, the odds of uterine fibroids were 90% greater (95% CI Z 1.0, 3.5) among those currently consuming at least 0.5 alcoholic drinks weekly compared with nondrinkers. The odds ratio with current drinking was strongest for small fibroids (OR Z 4.3; 95% CI Z 1.4, 12.9), and alcohol intake at age 30 was most strongly related to large tumors (OR Z 1.5; 95% CI Z 0.6, 3.7). There was no association of alcohol intake with uterine fibroids for black women (OR Z 1.0; 95% CI Z 0.7, 1.6), but the patterns for current and past drinking with fibroid size were generally similar to those for white women. CONCLUSION: This study suggests the involvement of alcohol intake in the initiation or early growth of uterine fibroids. doi:10.1016/j.annepidem.2004.07.083
P085S ACCURACY OF TIME-TO-PREGNANCY DATA FROM MEN RHN Nguyen, CR Weinberg, DD Baird, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC PURPOSE: Occupational studies of fertility often rely on male report of time-to-pregnancy (TTP). We investigated the accuracy of male report compared with TTP derived from detailed data collected from female partners. METHODS: In a study designed to measure effects of prenatal diethylstilbestrol (DES) on male reproduction, exposed and unexposed men from the Chicago DES cohort were interviewed by phone to assess fertility. The female partner of each male’s most recent pregnancy was interviewed separately. The TTP derived from the female data was used as the gold standard. Kappa (k) statistics were calculated to investigate male factors related to reporting accuracy. RESULTS: Of the 202 couples in which both partners reported a TTP, the male report was identical to the female-derived TTP in 36%, and in 75% it differed by no more than 2 months. Seventeen men had a high-school education or less, and their reporting was