• O Bougie, Ma I Yap, L Sikora, T Flaxman, and S Singh.
• Department of Obstetrics and Gynaecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
• BJOG. 2019 Aug 1; 126 (9): 1104-1115.

BackgroundUnderstanding the impact of race/ethnicity on the prevalence and presentation of endometriosis may help improve patient care.ObjectiveTo review systematically the evidence for the influence of race/ethnicity on the prevalence of endometriosis.Search StrategyCENTRAL, MEDLINE, PubMed, Embase, LILACS, SCIELO, and CINAHL databases, as well as the grey literature, were searched from date of inception until September 2017.Selection CriteriaRandomised control trials and observational studies reporting on prevalence and/or clinical presentation of endometriosis.Data Collection And AnalysisTwenty studies were included in the review and 18 studies were used to calculate odds ratio (OR) with 95% confidence interval (CI) through a random effects model. Methodological quality was assessed using the Newcastle-Ottawa risk of bias scale (NOS).Main ResultsCompared with White women, Black woman were less likely to be diagnosed with endometriosis (OR 0.49, 95% CI 0.29-0.83), whereas Asian women were more likely to have this diagnosis (OR 1.63, 95% CI 1.03-2.58). Compared with White women, there was a statistically significant difference in likelihood of endometriosis diagnosis in Hispanic women (OR 0.46, 95% CI 0.14-1.50). Significant heterogeneity (I2  > 50%) was present in the analysis for all racial/ethnic groups but was partially reduced in subgroup analysis by clinical presentation, particularly when endometriosis was diagnosed as self-reported, CONCLUSIONS: Prevalence of endometriosis appears to be influenced by race/ethnicity. Most notably, Black women appear less likely to be diagnosed with endometriosis compared with White women. There is scarce literature exploring the influence of race/ethnicity on symptomatology, as well as treatment access, preference, and response.Tweetable AbstractPrevalence of endometriosis may be influenced by race/ethnicity, but there is limited quality literature exploring this topic.© 2019 Royal College of Obstetricians and Gynaecologists.

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