RESUMO
BACKGROUND: Uterine leiomyoma has been reported to be a worse problematic disease for African American than Caucasian women in the US. Data are almost non-existent for other populations of African ancestry. Our aim was to investigate the hypothesis of an equivalent influence of ethnicity on uterine leiomyomas for women of a French African-Caribbean population. BASIC PROCEDURES: Retrospective analysis of hysterectomies performed from 2010 to 2015 at the teaching hospital of Guadeloupe (French West Indies), where most inhabitants are of West African origin, was carried out. Data of the 899 hysterectomies, including those for malignancy, were collected, in particular, uterine weight. MAIN FINDINGS: The indications were leiomyoma in 66.5 % of cases and leiomyomas were found in 91 % of all cases. The mean age and uterine weight were 51.7 years and 464 g for the entire population, 50.2 years and 488 g for the population without malignancies, and 47.0 years and 567 g for the population with leiomyomas. PRINCIPAL CONCLUSIONS: The data were compared to those reported in the literature for several populations, notably African Americans and Caucasians in the US and mainland France. This comparison supports the hypothesis that Guadeloupean women, an African-Caribbean population, have characteristics in terms of uterine leiomyoma that are close to those of African Americans. Although confirmation is required, these results highlight the need for specific research, therapeutic approaches, and improved early management of these populations.
Assuntos
Negro ou Afro-Americano/etnologia , Histerectomia , Leiomioma/etnologia , Leiomioma/cirurgia , Neoplasias Uterinas/etnologia , Neoplasias Uterinas/cirurgia , Adulto , África/etnologia , Região do Caribe/etnologia , Feminino , França/etnologia , Guadalupe/etnologia , Humanos , Estudos Retrospectivos , Estados Unidos/etnologia , População Branca/etnologiaRESUMO
BACKGROUND: Mass breast cancer screening is offered to French women between the ages of 50 and 74. In the French overseas department of Guadeloupe, where the population is of mostly African ancestry, a low age at diagnosis of breast cancer has been reported, as for African-Americans. This raises the question of whether breast cancer is more aggressive in the age group preceding that eligible for mass screening (40-49) in Guadeloupe. METHODS: We compared the tumor-related prognostic factors, first line therapy and overall survival rates of breast cancer cases diagnosed between the 40-49 and 50-74 age groups, based on reports of the cancer registry of Guadeloupe for the period 2008-2013. RESULTS: The characteristics studied, risk of death after breast cancer (HR 0.84 [95% CI: 0.58-1.22] and overall survival, did not differ significantly between the two groups, except for higher tumor size (28.8 vs 24.0; p=0.004) in the younger group. CONCLUSION: These results do not show a pattern of more aggressive breast cancer in the age group preceding that eligible for mass screening in Guadeloupe.
Assuntos
Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Adulto , Fatores Etários , Idoso , População Negra , Neoplasias da Mama/etnologia , Detecção Precoce de Câncer , Feminino , Guadalupe/epidemiologia , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Sistema de Registros , Taxa de SobrevidaRESUMO
BACKGROUND: Myoma is the most common benign tumor in women of childbearing age, with a high frequency in Afro-Caribbean than in other women. Depending on their number, size and location, myomas are suspected to be a cause of infertility. Conservative treatment by myomectomy is possible for symptomatic patients wishing to preserve their fertility. PURPOSE: The aim of this study was to evaluate the fertility of patients undergoing myomectomy in the University Hospital of Pointe-à-Pitre, Guadeloupe. METHODS: We conducted a retrospective study including all patients under age 42 who had conservative surgery from January 1st, 2005 to December 31st, 2009. The main judgment criteria were the occurrence of postoperative pregnancy and its outcome. RESULTS: Of 297 operated patients, 220 were interviewed by phone (74.1%), 124 (56.3%) had tried to obtain a pregnancy and 54 patients (43.5%) had 66 pregnancies (59.1% being live births and 25.8% miscarriages). For fertility after surgery, univariate analysis identified the number (more than 6, P = 0.0027) and an intramural location (P = 0.027) of myomas as negative factors and multivariate analysis identified age (over 35 years, RR = 2.45) and the association of other causes of infertility (RR = 2.21) as negative factors for pregnancy. CONCLUSION: The modest conception rate (43.5%) after myomectomy among those women trying to obtain a pregnancy may be linked to the specificities of our population, and in particular its relatively high age and the frequent association of multiple causes of infertility.