Epidemiological Features of Uterine Fibroid-associated Imaging Changes in Chinese Women of Reproductive Age: Real-World Study (Preprint)

BACKGROUND Uterine fibroids (UF), common benign tumors in women of reproductive age, confer substantial costs. The epidemiological characteristics of UF are unclear in China and Asia. OBJECTIVE This study investigated UF-associated imaging changes, and their prevalence, incidence, and risks in the Chinese population. METHODS This population-based retrospective analysis of multiyear (2017–2020) health examination data (n=33,915 female participants; age ≥15 years) from Nanchong, China included two expert consultation rounds to identify entries of UF-associated imaging changes and calculate prevalence and incidence of UF-associated imaging changes. Logistic regression estimated the association (odds ratio [OR], 95% confidence interval [CI]) of body mass index, high blood pressure, blood lipid profile, and fasting blood glucose level with UF-associated imaging changes. Age-stratified (≤40 and >40 years) risks were ascertained. RESULTS Besides “considering UF”, 17 entries of UF-associated imaging changes screened by the expert consultation were included, involving a total of 46,864 records (n=33,915), and crude prevalence=25.18%; crude incidence density/1000-woman-years=63.28. Incidence and prevalence increased with age during reproductive age (15–49 years) and decreased thereafter. The greatest burden was in 40–54 years women, the prevalence is 38.60%–45.38% and the incidence is 14.73%–17.96%. In the incident younger population (age ≤40 years), risk factors (OR [95% CI]) for UF-associated imaging changes were overweight, high blood pressure (1.48 [1.03–2.14] and 2.16 [1.10–4.24], respectively); in the >40 group, no association was observed. CONCLUSIONS UF incidence and prevalence in Asians were higher than previously reported, showed age-related increase in reproductive age, and UF incidence increased with overweight, high blood pressure in ≤40-year-old participants. Variation in UF burden and risk factors was noted in different age range, and risk factors identified in the younger women population make it possible to be early preventive measures for women with a higher risk of UF.