The goal of the Study of Environment, Lifestyle and Fibroids (SELF) is to identify risk factors for uterine fibroid development. It is the first study to identify incident cases based on ultrasound screening. We have enrolled a cohort of 1696 African-American women, ages 23-34, from the Detroit, Michigan area. Women with a prior diagnosis of fibroids were not eligible. Participants were screened for fibroids with ultrasound at enrollment and follow-up ultrasounds occurs approximately every 20 months to identify new fibroids. Fibroids that were detected at enrollment and those that arise during follow-up are monitored at subsequent visits for fibroid growth. We collected risk factor and symptom data, physical measurements, as well as blood, urine, and vaginal swab specimens at enrollment. Specimens and questionnaire data will be collected at each follow-up visit.
The study is designed to test three primary hypotheses:
- Vitamin D deficiency is a risk factor for fibroid incidence.
- Reproductive tract infection is a risk factor for fibroid incidence.
- A higher proportion of African ancestry is a risk factor for fibroid incidence.
In addition to testing the hypotheses, we collect a broad spectrum of information, including data on recognized risk factors, data on common exposures with inconsistent risk estimates in the literature, exposures of interest for which there is very limited data in the literature, and detailed symptom data.
In summary, this first prospective study of fibroid incidence tests important hypotheses regarding fibroid etiology. Our extra blood and urine specimens will be stored so that new hypotheses can be tested in the future. Our goal is to discover new strategies for prevention and suggest new approaches for treatment.