Black and Asian women are disproportionately affected by the presence of uterine fibroids found on transvaginal ultrasound (TVUS) compared to other women, according to a study published May 10 in JAMA Network Open.
Researchers led by Dr. David Huang from the University of California, San Francisco found that while fibroids are present in about one in five women, about 35% of Black women and about 21% of Asian women who participated in their study had fibroids shown on ultrasound, compared with about 10% of white women.
"We hope our findings will motivate appropriate recruitment of disproportionately affected groups in clinical trials so that health disparities associated with this pathology could be mitigated," Huang told AuntMinnie.com. "Health disparities in Asian women with fibroids should also be investigated."
Uterine fibroids are the most common neoplasm affecting females. The presence of these fibroids is tied to subfertility and early pregnancy loss and negatively affect obstetrical outcomes.
The researchers also noted that the prevalence of uterine fibroids, especially in Hispanic or Latina and Asian female individuals in the U.S., remains unknown. They added that it's not clear how prevalent fibroids are in young, asymptomatic female individuals.
Huang and co-authors wanted to estimate the proportion of women with uterine fibroids using a diverse, nonclinical, community-based study population consisting of reproductive-age women.
They collected data from 996 women with an average age of 35 years. This included 299 Asian women, 249 Black women, 237 Hispanic or Latina women, and 281 white women. All women underwent TVUS, which the researchers noted is a "highly sensitive and specific method in ascertaining fibroid burden."
The team found that fibroids were present in 199 women (20%). However, Black and Asian women had a higher proportion of fibroid presence compared with White and Hispanic or Latina women.
| Uterine fibroid presence and characteristics in women | |||||
| White | Hispanic or Latina | Asian | Black | p-value | |
| Presence of fibroids | 10.7% | 12.7% | 21.8% | 35.7% | N/A |
| Proportion of multiple fibroids | 33.3% | 33.3% | 26.0% | 48.3% | 0.06 |
| Largest average fibroid diameter | 3.2 cm | 3 cm | 3.2 cm | 3.9 cm | 0.03 |
Furthermore, Black and Asian women were statistically more likely to have fibroids than white women; Black women had an adjusted odds ratio of 4.72 (p < 0.001) for fibroids and Asian women had an adjusted odds ratio of 3.35 (p < 0.001) compared to reference.
Huang said this information will help researchers better understand how fibroids with certain characteristics may negatively impact reproductive health and should be proactively treated. The results stem from the University of California San Francisco Ovarian Aging Study, a longitudinal study of reproductive aging.
"Moving forward, I think it is important to have detailed documentation of fibroid size and location, especially in relation to the endometrial cavity," he told AuntMinnie.com. "A topic I hope to study is to better understand the natural course of uterine fibroids across a women's lifespan, which would also provide invaluable information for patient education and counseling."
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
