Objectives: Uterine Leiomyomas (fibroids) are common, benign tumors. In the US, approximately 70% of White and more than 80% of AA women are diagnosed with UF by age 50. Marked differences exist in disease presentation, severity, treatment, and outcomes for AA compared with White women. This study describes the treatment selection for women with incident UF and HMB in a predominantly AA population.

Methods: Using IBM-Watson’s MarketScan® Multi-state Medicaid claims database (2010-2019), a retrospective analysis examined baseline demographics, pre-index comorbidities, and treatment (e.g., surgery, hormone-based therapies) of women with incident UF and HMB. The index date was date of the first claim with a UF diagnosis. Women were required to be continuously enrolled ≥12 months pre- and ≥ 12 months post-index. Descriptive analyses of post-index treatment patterns and Cox regressions of time to treatment post UF diagnosis were performed using baseline characteristics as covariates.

Results: 24,129 women, [69.5% AA, 30.5% White (W)] were included. The mean (SD) age of the two groups was similar (AA:39.6 ± 7.11 years; W:40.2 ± 7.23 years). AA women were more likely to receive hormone-based therapy (42.4% vs 38.5%, p, 0.0001). Fewer AA women had a hysterectomy (AA:32.0% vs W:46.8%, p<0.0001). Cox regression models indicated that AA women were more likely to receive hormone-based therapy (HR=1.2, 95% CI: 1.130, 1.264, p<0.0001) and less likely to have a hysterectomy (HR=0.6, 95%CI: 0.579, 0.632, p<0.0001) than W women following a diagnosis for UF.

Conclusions: In this Medicaid population, selection of UF treatment differed between AA and W women. Previous studies showed a different pattern of care for AA women. Further analyses are needed to determine if these differences are socially meaningful.