EPIDEMIOLOGY OF UTERINE FIBROIDS: HISTOLOGICAL ASPECTS, DIAGNOSTICS, AND PREVALENCE IN WOMEN OF DIFFERENT AGE GROUPS

Abstract

Uterine fibroids represent a significant public health problem, affecting 20 to 80% of women of reproductive age. In Brazil, 409,502 hospitalizations were recorded between 2019 and 2023, representing a 32% increase, concentrated in the Northeast (42.2%) and predominantly affecting Black women (54.2%). This sought to describe the epidemiological profile of uterine fibroids, characterizing histological aspects, diagnostic methods, and prevalence across age groups, supporting prevention, diagnosis, and treatment strategies. To this end, an integrative review was adopted as the methodological approach of publications indexed in PubMed, LILACS, SciELO, and BVS (2020-2026), following PRISMA criteria. The results and discussion demonstrated that prevalence increases progressively with age, peaking between 40 and 49 years (19.68%). Significant racial disparities show Black women have 2 to 3 times higher risk. Histopathological analysis demonstrates morphological heterogeneity, with MED12 mutations in ~70% of cases, plus alterations in HMGA2, FH, and COL4A5-COL4A6. Transvaginal ultrasonography remains first-choice diagnostic method (cost-effective), complemented by magnetic resonance imaging in complex cases. Modifiable risk factors include early menarche, obesity, vitamin D deficiency, and endocrine disruptor exposure (BPA, BPS, BPAF). It can be concluded that uterine fibroids require active screening in primary care, standardized diagnostic protocols, educational interventions for vulnerable populations, and coordinated multidisciplinary approach.