Racial disparities between measures of area deprivation and financial toxicity, and uterine volume in myomectomy patients
Recommended Citation
Bossick AS, Abood JA, Oaks A, Vilkins A, Shukr G, Chamseddine P, and Wegienka GR. Racial disparities between measures of area deprivation and financial toxicity, and uterine volume in myomectomy patients. BMC Womens Health 2023; 23(1):603.
Document Type
Article
Publication Date
11-14-2023
Publication Title
BMC women's health
Abstract
BACKGROUND: At time of myomectomy, a surgical procedure to remove uterine fibroids, Black women tend to have larger uteri than White women. This makes Black patients less likely to undergo a minimally invasive myomectomy which has been shown to have less postoperative pain, less frequent postoperative fever and shorter length of stay compared to abdominal myomectomies. The associations between individual financial toxicity and community area deprivation and uterine volume at the time of myomectomy have not been investigated.
METHODS: We conducted a secondary data analysis of patients with fibroids scheduled for myomectomy using data from a fibroid treatment registry in [location]. We used validated measures of individual-level Financial Toxicity (higher scores = better financial status) and community-level Area Deprivation (ADI, high scores = worse deprivation). To examine associations with log transformed uterine volume, we used linear regression clustered on race (Black vs. White).
RESULTS: Black participants had worse financial toxicity, greater deprivation and larger uterine volumes compared with White participants. A greater Financial Toxicity score (better financial status) was associated with lower uterine volume. For every 10 unit increase in Financial Toxicity, the mean total uterine volume decreased by 9.95% (Confidence Interval [CI]: -9.95%, -3.99%). ADI was also associated with uterine volume. A single unit increase in ADI (worse deprivation) was associated with a 5.13% (CI: 2.02%, 7.25%) increase in mean uterine volume.
CONCLUSION: Disproportionately worse Financial Toxicity and ADI among Black patients is likely due to structural racism - which now must be considered in gynecologic research and practice.
TRIAL REGISTRATION: Not applicable.
Medical Subject Headings
Humans; Female; Uterine Myomectomy; Uterine Neoplasms; Financial Stress; Leiomyoma; Uterus
PubMed ID
37964227
Volume
23
Issue
1
First Page
603
Last Page
603
