Program seeks Council approval to issue a new initiative entitled, “Centers for Research on Health Disparities in Uterine Fibroids.” This initiative would support novel, synergistic research programs involving multiple, high-quality projects that span basic, clinical, translational, and social science research to address health disparities in uterine leiomyomas with the ultimate goal to improve modifiable aspects of the racial, ethnic, and socioeconomic disparities of this common gynecologic condition.
Approximately 70% of White women and 80-90% for Black women will get fibroids in their lifetime. UF symptoms include heavy menstrual bleeding and gushing which can lead to anemia; pelvic pain and pressure; urinary and bowel problems as the growing tumors press on the bladder and bowels; infertility; and adverse pregnancy outcomes as the birth canal becomes obstructed and the uterus becomes highly distorted. Fibroid burden goes beyond physical symptoms; some women with the condition experience significant distress that negatively affects quality of life, including depression, anxiety, and body image issues. UFs are the most common reason for hysterectomy.
UFs also represent arguably the largest health disparity in gynecologic health. African ancestry race is one of the most consistent risk factors for UF. Black women in the US are more likely to get fibroids, get them at a younger age (impacting reproduction), and suffer more severe symptoms, including anemia requiring blood transfusions, infertility, and detriments to quality of life. Further disparity beyond clinical phenotype manifest in health care system access and experience, leading to Black women being 2-3 times more likely to have a hysterectomy and 7 times more likely to have a myomectomy, despite effective non-surgical options that carry fewer complications. DESPITE THE ENORMITY OF THIS PROVEN HEALTH DISPARITY ACROSS EVERY ASPECT OF THE EXPERIENCE OF UTERINE FIBROIDS, THE REASONS FOR THE DISPARITY ARE STILL UNCLEAR.
This initiative proposes the support of two Centers for Research on Health Disparities in Uterine Fibroids. These centers will increase integrated research to improve our understanding of the biologic, behavioral, and environmental differences in risk, disease progression, and treatment that lead to the demonstrated health disparity; this research will forge a path towards greater health equity in diagnostics, treatments, and ultimate cure.
This initiative addresses priorities across three branches (GHDB, FIB, and CRB), the important NIH UNITE and NICHD STRIVE initiatives, and Theme 2 (Promoting Gynecologic, Andrologic, and Reproductive Health) and the weft topics of Health Disparities, Global Health, and Disease Prevention from the NICHD Strategic Plan.
Gynecologic Health and disease Branch (GHDB)
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