Is Endometriosis More Common Among Women of Certain Race/Ethnicity?

Race/ethnicity may influence the prevalence of endometriosis but more research is needed to establish the link.

Key Points

Highlights:

• Race/ethnicity seems to have an influence on the prevalence of endometriosis.

Importance:

• Understanding the impact of race/ethnicity on the prevalence of endometriosis is important as it can help improve patient care.

What's done here:

• A systematic review of the literature and meta‐analysis performed to understand the influence of race/ethnicity on the prevalence of endometriosis.

Key results:

• Black women seem less likely to be diagnosed with endometriosis compared to white women.
• Asian women are more likely to be diagnosed with endometriosis than white women.
• There is a statistically significant difference in the likelihood of endometriosis diagnosis in Hispanic women compared to white women.

Limitations

• The studies that were included in this meta-analysis were different in type and design and assessed different populations. There was also variability in the method used to diagnose endometriosis. 
• Race and ethnicity have different definitions with race referring to a category of people who share certain physical characteristics that are biologically inherited, and ethnicity referring to membership in a wide range of groups defined by culture, heritage, and national origin. However, race and ethnicity are often used interchangeably within the medical literature and may cause the results to appear more heterogeneous then they are. 
• The different racial/ethnic groups are not fully comparable especially in terms of socio-economic status and therefore access to healthcare, which may have a great influence on the diagnosis of endometriosis. 
• There may be a publication bias with a possibility that small studies suggesting that endometriosis is actually more common in black women compared to white women may be less likely to be selected for publication.

Lay Summary

Race/ethnicity seems to have an influence on the prevalence of endometriosis with black women appearing to be less likely to be diagnosed with the disease compared to white women. However, other factors such as access and response to treatment may also influence the rate of "endometriosis" diagnosis.

Understanding whether the prevalence of endometriosis really does differ between racial/ethnic groups can improve the ability of doctors to provide a timely and accurate diagnosis to all women and improve patient care.

In order to better understand the potential impact of race/ethnicity on the prevalence of endometriosis, Dr.Olga Bugie-Dr. Sukhbir Singh and colleagues conducted a systematic review of the literature and a meta‐analysis. They looked for randomized controlled trials and observational studies that reported on the prevalence and/or clinical presentation of endometriosis.

They identified 22 studies that fit their criteria and found that black women were less likely to be diagnosed with endometriosis compared to white women. On the other hand, Asian women were more likely to be diagnosed with the disease than white women. There was also a statistically significant difference in the likelihood of endometriosis diagnosis in Hispanic women compared to white women.

The researchers concluded that there was significant heterogeneity in the analysis for all racial/ethnic groups in terms of endometriosis diagnosis but this was partially reduced when subgroups by clinical presentation were analyzed.

Because of the scarcity of the literature exploring the effect of race/ethnicity on symptoms and access, preferences, and response to treatment, more research is needed to establish the relationship between race/ethnicity and the prevalence of endometriosis, the researchers concluded.

The study titled "Influence of race/ethnicity on prevalence and presentation of endometriosis: a systematic review and meta‐analysis" is published in the August 2019 issue of "British Journal of Obstetrics and Gynaecology".

Research Source: https://pubmed.ncbi.nlm.nih.gov/30908874/