Title : Racial disparities in surgical management of uterine fibroids: A systematic review
Abstract:
Purpose: The initiation of this study was driven by the notable impact of uterine fibroids on Black women, who face a significantly higher risk for these benign tumors compared to other demographics. Moreover, they experience disparities in surgical outcomes, a concern that persists even after adjusting for various health and socioeconomic factors. This study aims to explore these disparities and provide empirical evidence to guide improvements in clinical practices for the betterment of patient care and the promotion of health equity.
Methods: A comprehensive systematic review was conducted using Covidence to identify relevant studies published. The inclusion criteria focused on adult women from diverse racial and ethnic backgrounds, with particular attention on Black and Latinx populations undergoing surgical management for uterine fibroids. We considered a range of surgical interventions, including laparoscopic radiofrequency ablation, hysterectomy, and other minimally invasive approaches. Key outcomes evaluated included surgical efficacy, safety, patient satisfaction, and the psychosocial impact of uterine fibroids on treatment success and decision-making. Studies exclusively examining Caucasian or non-ethnic populations and those not addressing racial and ethnic disparities in surgical management were excluded.
Results: We conducted a search using Pubmed, Scopus, and Embase for all papers published from 2000 till present day. Our initial search in January 2024 produced 558 studies. We were able to screen these studies to 15 studies that fit our research question and goal. Findings suggest a higher propensity for Black women to undergo open hysterectomy, accompanied by a greater incidence of postoperative complications. This disparity remains significant even after controlling for medical, surgical, and gynecologic factors.
Discussion: Initial interpretations of the data indicate a greater likelihood of Black women undergoing more invasive surgeries for fibroids, facing increased complications thereafter. Such trends are independent of various health factors, hinting at underlying systemic issues. Financial strain and access to care appear to be disproportionately worse for Black patients, due to ingrained structural biases. Additionally, discrepancies in the utilization of minimally invasive surgeries among veterans suggest further need for research into the barriers faced by minority groups. The data points to a pressing need for a deeper understanding of the treatment experiences of Black patients to guide equitable care.
Audience Take Away:
- The Extent of Racial Disparities in Surgical Outcomes for Uterine Fibroids:** Understanding the disproportionate impact of surgical interventions on Black women, highlighting the need for systemic changes in clinical practice.
- Importance of Patient-Centered Care in Addressing Health Disparities: Insights on how healthcare providers can implement more inclusive strategies and interventions, improving the quality of care for minority populations.
- Empirical Evidence to Guide Clinical Practice: The presentation will offer a comprehensive overview of the existing research, providing attendees with actionable data to advocate for and implement changes in their practice settings.
- Potential for Future Research and Policy Change: Encouraging other faculty and healthcare professionals to delve deeper into health disparities research, fostering a collaborative effort to address and reduce these inequities.
- Practical Solutions to Improve Healthcare Equity: Discussion on how the findings can inform the development of policies and practices that ensure equitable access to minimally invasive treatments and improved surgical outcomes for all patients, regardless of race.
