Uterine Fibroids Among Caribbean and African Women in the UK: A Rapid Scoping Review

BackgroundUterine fibroids (leiomyomas) are common benign tumours affecting women in the UK, with women of African and Caribbean descent reporting a higher prevalence, early onset, and greater symptom severity compared to other ethnic groups. Despite this known disparity, there is a paucity of specific evidence regarding the prevalence, risk factors, management, and outcomes for this population within the UK healthcare context. ObjectiveTo conduct a rapid scoping review aimed at identifying, mapping, and synthesising the existing UK-based evidence concerning uterine fibroids among women of African and/or Caribbean ancestry. MethodsA search strategy was developed and used in MEDLINE, CINAHL, and the Cochrane Library to identify empirical studies conducted in the UK and reporting on any aspect of uterine fibroids (genetics, risk factors, clinical presentation, treatment, quality of life (QoL), complications, healthcare access, patient experiences, etc) in self-identified African and/or Caribbean women. Grey literature sources were also included in the searches. Data from the included articles and reports were extracted and synthesized narratively. ResultsThe search identified six studies conducted between 2014 and 2021. These included 1 genome-wide association study (GWAS), 1 clinical trial, 2 observational studies, and 2 case reports. Key findings suggest a genetic predisposition to uterine fibroids, with GWAS data identifying shared and ancestry-specific loci relevant to UK women of African ancestry. Treatment evidence also showed that compared to Uterine Artery Embolisation (UAE), myomectomy offered better QoL outcomes, especially for women seeking uterine preservation. There was also evidence showing longer post-surgical recovery times for Black women after myomectomy, as well as reports of rare but severe complications associated with the condition. The potential role of Vitamin D deficiency as a risk factor for uterine fibroids among Black women in the UK was also reported. ConclusionThis review confirms the significant burden of uterine fibroids among African and Caribbean women in the UK and highlights a critical lack of focused research. Research priorities should include large-scale epidemiological studies to understand the risk or protective factors associated with the progression of the condition (including the role of Vitamin D). Future work should also include comparative effectiveness trials to identify the most relevant treatment options, as well as a further exploration of patient experiences. Our findings underscore the need for culturally competent clinical care, improved patient awareness, equitable access to diverse treatment options, and targeted policy initiatives to address health disparities in uterine fibroid management for Black women in the UK.