American Journal of Epidemiology Advance Access originally published online on November 7, 2006
American Journal of Epidemiology 2007 165(2):157-163; doi:10.1093/aje/kwj363
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ORIGINAL CONTRIBUTIONS |
Association of Physical Activity with Development of Uterine Leiomyoma
1 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
2 Biostatistics Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
3 Department of Radiology, George Washington University Medical Center, George Washington University, Washington, DC
4 Coda Research, Inc., Research Triangle Park, NC
5 Department of Health Care Sciences, George Washington University Medical Center, George Washington University, Washington, DC
Correspondence to Dr. Donna Baird, Epidemiology Branch, A3-05, 111 TW Alexander Drive, Building 101, Room 308, National Institute of Environmental Health Sciences, P.O. Box 12233, Research Triangle Park, NC 27709 (e-mail: baird{at}niehs.nih.gov).
The relation between physical activity and uterine leiomyomata (fibroids) has received little study, but exercise is protective for breast cancer, another hormonally mediated tumor. Participants in this study were randomly selected members of a health plan based in Washington, DC, aged 35–49 years (734 African Americans, 455 Whites) enrolled between 1996 and 1999. Fibroid status was based on ultrasound screening. Physical activity was based on detailed interview questions. Logistic regression with adjustment for body mass index and other risk factors showed that women in the highest category of physical activity were significantly less likely to have fibroids (odds ratio = 0.6, 95% confidence interval = 0.4, 0.9 for the highest vs. the lowest category (equivalent to approximately 
7 hours/week vs. <2 hours/week)). There was a dose-response pattern; a significant trend was seen for both African-American and White women. A multistate Bayesian analysis indicated that exercise was associated with tumor onset more strongly than with tumor growth. When data for women who reported major fibroid-related symptoms were excluded, results remained essentially unchanged, suggesting that the observed association could not be attributed to reverse causation (fibroids preventing exercise). The authors concluded that regular exercise might help women prevent fibroids.
body mass index; causality; exercise; leiomyoma; ultrasonics
Abbreviations: BMI, body mass index
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