MONDAY, March 24 (HealthDay News) -- A new review of 32 studies
suggests that obese women -- particularly white women -- are more
likely than others to skip screenings for breast and cervical
cancer.
No one knows why extra pounds lessen the likelihood that women
will avoid mammograms or Pap smears. And it's not known why obesity
seems to have no significant effect on colorectal screening, the
researchers said.
However, the findings do point to a problem that deserves
attention in the doctor's office, said study lead author Sarah S.
Cohen, a graduate student in the department of epidemiology at the
University of North Carolina at Chapel Hill.
"Because obesity is becoming an increasing problem in our
health-care system, encouraging women who are overweight and obese
to be screened may be especially important," she said. "It's
important for physicians to address it and encourage women to be
screened."
According to Cohen, the screening rates for breast and cervical
cancer are fairly high. About 75 percent of American women receive
mammograms every year or two after the age of 40, she said, while
about 85 percent of women get Pap smears to test for cervical
cancer.
The screening rates for colorectal cancer are much lower,
perhaps around a third of women, she said.
The new review, published in the May 1 issue of the journal
Cancer, examined 32 studies looking at breast cancer (10
studies), cervical cancer (14) and colorectal cancer (eight
studies). The studies typically defined obese women as those having
a body mass index [BMI, a ratio of weight to height] of 30 or
above. That means they were more than merely overweight as defined
by national guidelines.
Overall, obese women were 10 percent to 40 percent less likely
to be screened for breast and cervical cancer compared to other
women, Cohen said. Black women, however, seemed to be much less
affected by obesity when it came to the screenings.
There are many theories why heavier women might be less likely
to undergo health screenings, Cohen said. "It may be related to
patients' emotional barriers, things like embarrassment and fear of
being weighed. It may be provider-bias, physicians having a bias
against obese patients. And [obese women] have other health-care
needs, like dealing with high cholesterol."
Another possibility is that medical equipment may not be sized
properly to accommodate larger patients, Cohen said. "None of this
has been studied in any quantitative way," she added.
Dr. Massimo Cristofanilli, an associate professor in the
department of breast medical oncology at the University of Texas
M.D. Anderson Cancer Center in Houston, said another possibility
was that "women with low-incomes choose high-caloric foods and have
difficulty in being particularly careful with their lifestyle. They
may also be largely uninsured and have minimal access to screening
programs."
"We should recognize that prevention of obesity is a critical
issue," Cristofanilli added. "Education about a healthy lifestyle
should start at school and continue through media and in the
family."
More information
To calculate your BMI, visit the U.S.
National
Heart, Lung, and Blood Institute.
