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 heighten 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."
Source : Health Day
