Epidemiology of uterine fibroids: A systematic review

Elizabeth A Stewart, Cl Cookson, Ra Gandolfo, R. Schulze-Rath

Research output: Contribution to journalArticle

124 Scopus citations


Background: Uterine fibroids (UFs) are the most common neoplasm affecting women that can cause significant morbidity and may adversely impact fertility. Objectives: To examine UF epidemiology and to evaluate the relative strengths of putative risk factors. Search strategy: MEDLINE and Embase were searched for studies published in English between January 1995 and April 2015. Selection criteria: Publications reporting relevant data from registries and other observational studies with over 1000 patients and single-centre studies with over 100 patients were selected. Data collection and analysis: Data on UF incidence, prevalence and associated risk factors were extracted from 60 publications. Main results: Wide ranges were reported in both UF incidence (217-3745 cases per 100 000 women-years) and prevalence (4.5-68.6%), depending on study populations and diagnostic methods. Black race was the only factor that was recurrently reported to increase UF risk, by two-threefold compared with white race. Eleven other factors affected UF risk to a magnitude similar to or greater than race. Age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption increased UF risk; use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate, smoking in women with low body mass index and parity reduced UF risk. Conclusions: We identified 12 risk factors that play an important role in UF epidemiology. The UF risk factor with the strongest evidence is black race. High-quality prospective observational data are needed to improve our understanding of UF epidemiology, and thus its aetiology and optimal management. Tweetable abstract: Uterine fibroids occur in about 70% of women. Black race and 11 other factors affect uterine fibroid risk.

Original languageEnglish (US)
JournalBJOG: An International Journal of Obstetrics and Gynaecology
StateAccepted/In press - 2017


  • Epidemiology
  • Incidence
  • Leiomyoma
  • Prevalence
  • Race
  • Risk factors
  • Uterine fibroids

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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