Elevated risk for premature death found in age-adjusted models; association strengthened after adjustment for confounders
By Elana Gotkine HealthDay Reporter
THURSDAY, Nov. 21, 2024 (HealthDay News) — Women with a history of endometriosis and uterine fibroids may have an increased risk for premature mortality, according to a study published online Nov. 20 in The BMJ.
Yi-Xin Wang, M.D., Ph.D., from Shanghai Jiao Tong University, and colleagues conducted a prospective cohort study involving 110,091 women aged 25 to 42 years in 1989 without a history of hysterectomy before endometriosis or fibroids diagnosis, cardiovascular diseases, or cancer to assess the effect of endometriosis and uterine fibroids on the long-term risk for premature mortality (<70 years).
During 2,994,354 person-years of follow-up, 4,356 premature deaths were recorded, including 1,459 from cancer, 304 from cardiovascular diseases, and 90 from respiratory diseases. The researchers found that for women with and without laparoscopically confirmed endometriosis, the crude incidence of all-cause premature mortality was 2.01 and 1.40 per 1,000 person-years, respectively. Laparoscopically confirmed endometriosis was associated with a hazard ratio of 1.19 for premature death in age-adjusted models; after adjustment for potential confounders, including behavioral factors, these models were strengthened (hazard ratio, 1.31). The association was mainly driven by senility and ill-defined disease, nonmalignant respiratory diseases, diseases of the nervous system and sense organs, and malignant neoplasms of gynecological organs (hazard ratios, 1.80, 1.95, 2.50, and 2.76, respectively). There was no association seen for ultrasound or hysterectomy-confirmed uterine fibroids with all-cause premature mortality, but associations were seen with an increased risk for mortality from malignant neoplasm of gynecological organs (hazard ratio, 2.32).
“These findings highlight the importance for primary care providers to consider both conditions in their assessment of women’s health,” the authors write.
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