{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:51:13Z","timestamp":1790167873143,"version":"4.1.0"},"reference-count":258,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:00:00Z","timestamp":1699056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health (NIH)","award":["RO1 ES028615"],"award-info":[{"award-number":["RO1 ES028615"]}]},{"name":"National Institutes of Health (NIH)","award":["RO1 HD094378"],"award-info":[{"award-number":["RO1 HD094378"]}]},{"name":"National Institutes of Health (NIH)","award":["U54 MD007602"],"award-info":[{"award-number":["U54 MD007602"]}]},{"name":"National Institutes of Health (NIH)","award":["RO1 HD087417"],"award-info":[{"award-number":["RO1 HD087417"]}]},{"name":"National Institutes of Health (NIH)","award":["RO1 HD106285"],"award-info":[{"award-number":["RO1 HD106285"]}]},{"name":"society of endometriosis and uterine disorders (SEUD) Research Grant","award":["RO1 ES028615"],"award-info":[{"award-number":["RO1 ES028615"]}]},{"name":"society of endometriosis and uterine disorders (SEUD) Research Grant","award":["RO1 HD094378"],"award-info":[{"award-number":["RO1 HD094378"]}]},{"name":"society of endometriosis and uterine disorders (SEUD) Research Grant","award":["U54 MD007602"],"award-info":[{"award-number":["U54 MD007602"]}]},{"name":"society of endometriosis and uterine disorders (SEUD) Research Grant","award":["RO1 HD087417"],"award-info":[{"award-number":["RO1 HD087417"]}]},{"name":"society of endometriosis and uterine disorders (SEUD) Research Grant","award":["RO1 HD106285"],"award-info":[{"award-number":["RO1 HD106285"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Uterine fibroids (UFs) are common tumors in women of reproductive age. It is imperative to comprehend UFs\u2019 associated risk factors to facilitate early detection and prevention. Simple relying on surgical\/pharmacological treatment of advanced disease is not only highly expensive, but it also deprives patients of good quality of life (QOL). Unfortunately, even if the disease is discovered early, no medical intervention is traditionally initiated until the disease burden becomes high, and only then is surgical intervention performed. Furthermore, after myomectomy, the recurrence rate of UFs is extremely high with the need for additional surgeries and other interventions. This confused approach is invasive and extremely costly with an overall negative impact on women\u2019s health. Secondary prevention is the management of early disease to slow down its progression or even halt it completely. The current approach of watchful observation for early disease is considered a major missed opportunity in the literature. The aim of this article is to present an approach named the ESCAPE (Evidence-Based Approach for Secondary Prevention) of UF management. It comprises simple, inexpensive, and safe steps that can arrest the development of UFs, promote overall reproductive health, decrease the number of unnecessary surgeries, and save billions of health care systems\u2019 dollars worldwide.<\/jats:p>","DOI":"10.3390\/ijms242115972","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T14:51:01Z","timestamp":1699109461000},"page":"15972","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Evidence-Based Approach for Secondary Prevention of Uterine Fibroids (The ESCAPE Approach)"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0758-2133","authenticated-orcid":false,"given":"Somayeh","family":"Vafaei","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5780-5983","authenticated-orcid":false,"given":"Micha\u0142","family":"Ciebiera","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 00-189 Warsaw, Poland"},{"name":"Warsaw Institute of Women\u2019s Health, 00-189 Warsaw, Poland"},{"name":"Development and Research Center of Non-Invasive Therapies, Pro-Familia Hospital, 35-302 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervat M.","family":"Omran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0279-6730","authenticated-orcid":false,"given":"Mohammad Mousaei","family":"Ghasroldasht","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-8946","authenticated-orcid":false,"given":"Qiwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Leake","sequence":"additional","affiliation":[{"name":"The White Dress Project, Atlanta, GA 30309, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rochelle","family":"Wolfe","sequence":"additional","affiliation":[{"name":"The White Dress Project, Atlanta, GA 30309, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-6691","authenticated-orcid":false,"given":"Mohamed","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8778-4447","authenticated-orcid":false,"given":"Ayman","family":"Al-Hendy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"319.e1","DOI":"10.1016\/j.ajog.2013.07.017","article-title":"The impact of uterine leiomyomas: A national survey of affected women","volume":"209","author":"Borah","year":"2013","journal-title":"Am. 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