Fibroids in the uterus (womb) affect Black women 2-3 times more often than white women. They can cause pain and bleeding and can lead to hysterectomy. Tobacco, alcohol, and caffeine consumption could influence the risk of uterine fibroids through changes in female hormones. We assessed this possibility with data from the BWHS collected during 1997 through 2001. During that time period, 2,177 premenopausal women reported the occurrence of a uterine fibroid diagnosed through ultrasound or hysterectomy. The risk of fibroids was not associated with cigarette smoking but it was associated with alcohol consumption, particularly consumption of beer. Women who drank at least 7 beers a week had a greater risk of fibroids than nondrinkers. Fibroids were not associated with coffee drinking in women overall, but among women under 35 years of age those who drank at least 3 cups a day appeared to have a higher risk of fibroids than nondrinkers. These findings are new and require confirmation in further studies. If confirmed, modifiable risk factors for fibroids–alcohol and coffee consumption– will have been identified. link to online article

We assessed whether hair relaxer use is associated with preterm birth (baby born at least 3 weeks early) in the BWHS. We compared 497 babies born preterm because of premature rupture of membranes or premature labor for no known reason with 5633 full-term babies, whose births were reported on the 1997, 1999, and 2001 health questionnaires. There were no differences in hair relaxer use between mothers of the preterm and full-term babies, suggesting that hair relaxer use does not influence the occurrence of preterm birth.

We assessed whether characteristics of the neighborhood in which BWHS participants live are associated with cigarette smoking, as reported in 1995. Information on the poverty level of the census tracts in which BWHS participants live was obtained from the U.S. Census. After taking into account women’s age, education, marital status, and occupation, it was found that the percent of women who were current smokers increased as the percent of residents below the poverty level increased. These findings suggest that characteristics of women’s neighborhoods play a role in smoking behavior above and beyond individual characteristics.

Although uterine fibroids are a major problem among Black women, there is relatively little information on age-specific rates of occurrence. The BWHS provides the most informative information to date on this question. Based on 2,279 new occurrences of fibroids confirmed by ultrasound or hysterectomy that were reported by BWHS participants on the 1999 and 2001 health questionnaires, the incidence rate was 17.8 per 1000 women per year at ages <30, peaked at 39.8 per 1000 women per year at ages 40-44, and then decreased.

Neighborhoods have characteristics that could affect health (e.g., by affecting stress levels or the ability to exercise). We assessed whether neighborhood socioeconomic status (SES) is associated with the occurrence of hypertension (high blood pressure) in the BWHS. Information on the SES of neighborhoods was obtained from the U.S. Census. During 1995-2001 4,895 BWHS participants reported having been diagnosed with hypertension for the first time. After taking into account individual characteristics such as age, weight, education, smoking, and exercise, we found that lower neighborhood SES was associated with a higher occurence of hypertension. This suggests that neighborhood environment may be contributing to the excess of hypertension among Black women in the U.S.

On the 1997 BWHS health survey, participants completed 9 questions about unfair treatment in everyday life and experiences of racial discrimination on the job, in housing and in police encounters. Preliminary analyses show no relationship of these experiences to the occurrence of breast cancer. The relationship of racial discrimination to the stage at which breast cancer is diagnosed will be assessed in future analyses.

On the 1999 BWHS health survey, participants completed 20 questions, the “CES-D” scale which is a measure of feelings of depression. The present analysis found that older and younger women differed in the types of symptoms they reported, and that depression scores were lower for older women, married women, and those with higher levels of education. The relation of depression scores to the occurrence of various illnesses will be assessed in future analyses.

There has been controversy about whether having an abortion might increase the risk of breast cancer, although the weight of evidence from large and well-conducted studies indicates that there is no effect. There has been very little study of abortion and breast cancer in African-American women. Based on data collected in the BWHS, induced abortion was not associated with the occurrence of breast cancer. Also, the number of abortions or the age at which the abortion occurred did not influence the risk of breast cancer. These results from the BWHS indicate clearly that induced abortion does not increase the risk of breast cancer in African-American women. link to online article

Uterine fibroids occur 2-3 times more commonly in Black women than white women. During follow-up of BWHS participants through 2001, over 2000 women developed uterine fibroids. Based on data on reproductive history and other factors, we found that risk of fibroids was lower for women who had a later age at start of menstruation, a later age at the birth of their first child, more children, or a recent birth. Women who used progestin-only injectable contraceptives also appeared to have a reduced risk. This is the largest follow-up study of uterine fibroids in Black women yet conducted. The results confirm that reproductive history plays an important role in the occurrence of fibroids and are useful for elucidating mechanisms of occurrence. link to online article

Genetic polymorphisms may influence the occurrence of some diseases. To test hypotheses concerning genetic polymorphisms, DNA samples are needed. Cheek cells are an excellent source of DNA. A study in which over 1000 BWHS participants took part demonstrated that it is feasible to collect cheek cell samples by mail. Two collection methods were tested—swishing the mouth with mouthwash, and swabbing the cheek with a soft brush. Both methods were acceptable to participants but the mouthwash method yielded much larger amounts of DNA. Cheek cell samples through mouthwash are being collected from all BWHS participants willing to provide them. link to online article