Disparities in the Diagnosis and Management of Endometriosis and Fibroids among Black African and Black Caribbean Women in High Income Countries: A Rapid Review
1
The Feminist Health CIC, Reading, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
This rapid review examines inequalities in diagnoses and treatment of endometriosis and fibroids in Black African and Black Caribbean women living in high-income countries, highlighting the role of racial bias in healthcare systems.
METHODS:
Three literature reviews were conducted to examine risk factors for prevalence and management of endometriosis and fibroids in Black African and Black Caribbean women living in high-income countries. A rapid review approach was undertaken using search engines to identify and screen relevant studies. Selection criteria included literature focused on the target populations, high-income settings, and which addressed management or risk factors. Thematic analyses were used to identify and interpret common themes within the data.
RESULTS:
After screening by multiple reviewers, 86 articles on management (50 endometriosis, 36 fibroids) and 62 articles on causes and risk factors (58 fibroids, 4 endometriosis) were included. For fibroids, the most reported risk factors were genetic and molecular (34.5%), followed by nutritional and metabolic (32.8%). Environmental, epigenetic, psychological, and stress-related factors each accounted for 10.3%, reproductive and hormonal factors for 8.6%, and biological processes for 6.9%. For endometriosis, most identified risk factors related to biological mechanisms, with genetic/molecular and reproductive factors each representing 25%. Key themes identified included racial disparities and socio-economic influences in diagnoses and treatment due to bias in healthcare systems and research leading to delays and poorer outcomes. While fibroids are more prevalent and severe in Black women, both conditions show significant racial gaps, with Black women experiencing longer diagnostic delays, underdiagnosis of endometriosis, less access to specialist care, and worse surgical outcomes.
CONCLUSIONS:
This review identifies important risk factors and inequities in the care of fibroids and endometriosis among Black, African, and Caribbean women in high-income countries. However, the evidence is limited, highlighting urgent need for more inclusive research to guide equitable and culturally competent care.
This rapid review examines inequalities in diagnoses and treatment of endometriosis and fibroids in Black African and Black Caribbean women living in high-income countries, highlighting the role of racial bias in healthcare systems.
METHODS:
Three literature reviews were conducted to examine risk factors for prevalence and management of endometriosis and fibroids in Black African and Black Caribbean women living in high-income countries. A rapid review approach was undertaken using search engines to identify and screen relevant studies. Selection criteria included literature focused on the target populations, high-income settings, and which addressed management or risk factors. Thematic analyses were used to identify and interpret common themes within the data.
RESULTS:
After screening by multiple reviewers, 86 articles on management (50 endometriosis, 36 fibroids) and 62 articles on causes and risk factors (58 fibroids, 4 endometriosis) were included. For fibroids, the most reported risk factors were genetic and molecular (34.5%), followed by nutritional and metabolic (32.8%). Environmental, epigenetic, psychological, and stress-related factors each accounted for 10.3%, reproductive and hormonal factors for 8.6%, and biological processes for 6.9%. For endometriosis, most identified risk factors related to biological mechanisms, with genetic/molecular and reproductive factors each representing 25%. Key themes identified included racial disparities and socio-economic influences in diagnoses and treatment due to bias in healthcare systems and research leading to delays and poorer outcomes. While fibroids are more prevalent and severe in Black women, both conditions show significant racial gaps, with Black women experiencing longer diagnostic delays, underdiagnosis of endometriosis, less access to specialist care, and worse surgical outcomes.
CONCLUSIONS:
This review identifies important risk factors and inequities in the care of fibroids and endometriosis among Black, African, and Caribbean women in high-income countries. However, the evidence is limited, highlighting urgent need for more inclusive research to guide equitable and culturally competent care.
| eISSN: | 2654-1459 |
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