Clinico-Histopathological Assessment of Uterine Fibroid Cases Examined at The Ghana Standards Authority Laboratory

Abstract

Background: Uterine fibroids (UFs), also known as uterine leiomyomas or myomas, are benign tumours of the smooth muscle layer of the uterus. Globally, the incidence and prevalence rates of fibroids obtained from the Global Burden of Disease (GBD) 2019 were very high. UFs are associated with considerable hospitalisations of women affected, and also have a negative impact on their quality of life. The aim of this study was to conduct a clinico-histopathological assessment of uterine fibroid cases examined at the Ghana Standards Authority (GSA) from the year 2013 to the year 2021. Methods: A repeated cross-sectional study was employed to identify the pattern of UFs in Ghana, the symptoms presented by women with UFs, and other reproductive tract lesions commonly reported with UFs from February, 2013 to December, 2021. Data were obtained from the histopathology laboratory of the GSA. A negative binomial regression was used to assess the pattern of increase of UF cases, and descriptive statistics for the symptoms experienced by participants using STATA 18. Descriptive statistics and binary logistic regression were employed to identify the lesions co-existing with UFs and the relationship with participants’ age respectively. Results: The total number of UF cases was 6,753, out of which 1,816 had co-existing reproductive tract tumours/lesions. The overall mean age was 41±8.23 years, with an age range of 17-88 years. 3, 358 (49.73%) UF cases were in the age group of 37-47 years, and the age group 15-25 years had the least number of cases. Pelvic mass was the most dominant symptom presented by 6, 234 (92.31%) participants. For co-existing lesions, adenomyosis was the most preponderant followed by ovarian and cervical lesions. Malignant tumours of the uterus, cervix, and ovary were also identified. There was a limited association between the age and these co-existing lesions. Conclusion: The fibroid cases demonstrated an increasing pattern by 22.2% for every additional year from 2013 to 2021. The clinical presentations and the presence of both benign and malignant pathologies of the female reproductive tract in addition to uterine fibroids among Ghanaian women call for the provision of screening programmes for women aged above 30 years.