Influence of race/ethnicity on prevalence and presentation of endometriosis: A systematic review and meta-analysis
CANSAGE ePoster Library. Bougie O. 09/27/19; 275243; eP-110
Dr. Olga Bougie
Dr. Olga Bougie
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Abstract
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Objective: To systematically review the evidence for the influence of race/ethnicity on the prevalence of endometriosis.Methods: CENTRAL, Medline, PubMed, Embase, LILACS, SCIELO, and CINAHL databases, as well as the grey literature, were searched from date of inception until September 2017. Randomized control trials and observational studies reporting on prevalence and/or clinical presentation of endometriosis were included in the review. The primary outcome examined was likelihood of endometriosis diagnosed in each ethnic group. An odds ratio was calculated using a random effects model. Methodological quality was assessed using the Newcastle-Ottawa risk of bias Scale (NOS). Results: Initial query yielded 1180 studies, which was subsequently narrowed to 20 studies in the qualitative review and 18 in the meta-analysis. Compared to White women, Black woman were less likely to be diagnosed with endometriosis (OR 0.49, 95% CI 0.29-0.83), while Asian women were more likely to have this diagnosis (OR 1.63, 95% CI 1.03-2.58). Compared to White women, there was a statistically significant difference in likelihood of endometriosis diagnosis in Hispanic women (OR 0.46, 95% CI 0.14-1.50). Significant heterogeneity (I2>50%) was present in the analysis for all racial/ethnic groups, but was partially reduced in subgroup analysis by clinical presentation, particularly when endometriosis was diagnosed as self-reported, Conclusions: Prevalence of endometriosis appears to be influenced by race/ethnicity. Most notably, Black women appear less likely to be diagnosed with endometriosis compared to White women. There is scarce literature exploring the influence of race/ethnicity on symptomatology, as well as treatment access, preference and response.
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