Body mass index and cancer screening: Findings from the English Longitudinal Study of Ageing

Beeken, Rebecca J; Wilson, R.; McDonald, Laura; Wardle, Jane

doi:10.1177/0969141314531409

Cited by 18 publications

(22 citation statements)

References 32 publications

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“…Results from the meta-analyses suggest that having private health insurance, having had cervical screening, and positive health beliefs (e.g., motivation and perceived benefits) are significantly associated with a higher level of breast cancer screening attendance. However, in the current review only two studies (Beeken, Wilson, McDonald, & Wardle, 2014;Tekkel et al, 2011) reported data for morbidly obese participants, and in each study, the proportion of included participants was lower (4-8%) than the 10% of morbidly obese women in the United States (Fryar, Carroll, & Ogden, 2018). The narrative synthesis highlighted factors associated with both screening attendance and help-seeking behaviour.…”

Section: Discussionmentioning

confidence: 81%

“…The Maruthur study also reported lower screening rates among morbidly obese women. However, in the current review only two studies (Beeken, Wilson, McDonald, & Wardle, 2014;Tekkel et al, 2011) reported data for morbidly obese participants, and in each study, the proportion of included participants was lower (4-8%) than the 10% of morbidly obese women in the United States (Fryar, Carroll, & Ogden, 2018).…”

Section: Discussionmentioning

confidence: 81%

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Health and health belief factors associated with screening and help‐seeking behaviours for breast cancer: A systematic review and meta‐analysis of the European evidence

Grimley

Kato²,

Grunfeld

2019

British J Health Psychol

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Purpose. The aim of this systematic review was to identify health or health belief factors associated with mammography attendance or with self-initiated medical help-seeking for breast cancer symptoms among women in Europe.Methods. Five databases were searched for articles published between 2005 and 2018. Meta-analyses were conducted for 13 factors related to screening attendance and two factors associated with help-seeking behaviour. Where there were too few studies to include in the meta-analysis, a narrative synthesis was undertaken.Results. Sixty-five studies were included. Never having had cervical screening (d = À.72, p < .001) and higher perceived barriers to mammography (d = À.40, p < .001) were associated with lower levels of screening attendance. Possessing health insurance (d = .49, p < .001), greater perceived benefits (d = .31, p < .001) and motivation (d = .36, p = .003) towards screening, and higher perceived seriousness (d = .24, p = .019) and susceptibility (d = .20, p = .024) towards breast cancer were associated with a higher level of screening attendance. Presenting with a non-lump symptom was associated with a longer time to presentation (d = .32, p < .001). The narrative synthesis revealed that previous benign breast disease was associated with a higher level of screening attendance but with a longer time to presentation.Conclusions. The review identified key similarities in factors associated with screening and help-seeking behaviours which offer scope for combined interventions aimed at women that target both behaviours. Furthermore, the review highlighted that fewer studies have focused on help-seeking behaviour, despite two thirds of breast cancer cases being self-detected. Future research should further examine predictors of help-seeking behaviour including a focus on modifiable factors, such as BMI, and physical activity. What is already known on this subject?Attending regular breast screening appointments and seeking help promptly on self-discovery of a breast symptom are important as early detection has been shown to be associated with better prognosis. Demographic, socio-economic, and health factors are predictors of screening and help-seeking behaviours.Both screening and help-seeking behaviours are potential health care-avoiding actions, and women who delay seeking help for a breast symptom are also less likely to attend screening. What does this study add?This study provides evidence of shared health beliefs and health factors that predict both screening attendance and help-seeking, which could be targeted in future combined health interventions to promote early detection. Health factors associated with screening attendance in Europe may differ from other locations, such as the United States and Australia. This study provides a call to action for more European research examining help-seeking behaviour using quantitative methodology and larger samples.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 81%

Health and health belief factors associated with screening and help‐seeking behaviours for breast cancer: A systematic review and meta‐analysis of the European evidence

Grimley

Kato²,

Grunfeld

2019

British J Health Psychol

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“…Alternatively, interval advances in addressing weight‐related barriers may explain apparent improvements in mammography screening disparities among women from different BMI categories over time. Specifically, as the prevalence of obesity has increased, it is likely that previously described patient‐level and facility‐level barriers such as physician attitudes toward obese patients and the availability of oversized gowns and re‐enforced equipment for women above certain weight limits may have been improved …”

Section: Discussionmentioning

confidence: 99%

“…Specifically, as the prevalence of obesity has increased, it is likely that previously described patient-level and facility-level barriers such as physician attitudes toward obese patients and the availability of oversized gowns and re-enforced equipment for women above certain weight limits may have been improved. 35,36 In addition, prior studies evaluating screening behaviors in obese women have focused on differences in mammography adherence between racial/ethnic groups, primarily between black and white women. To the best of our knowledge, there has been limited information published concerning screening adherence in obese women from other racial/ethnic groups, largely due to small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

Obesity and breast cancer screening: Cross‐sectional survey results from the behavioral risk factor surveillance system

Miles

Lehman

Mercaldo

et al. 2019

Cancer

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Background Postmenopausal obese women demonstrate an elevated breast cancer risk and experience increased breast cancer morbidity and mortality compared with women with a normal body mass index (BMI). However, to the authors' knowledge, prior studies have yielded inconclusive results regarding the effects of obesity on mammography screening adherence. Using national cross‐sectional survey data, the objective of the current study was to assess the current association between increasing BMI and use of mammography screening. Methods Cross‐sectional survey data from the 2016 Behavioral Risk Factor Surveillance System, a state‐based national telephone survey of noninstitutionalized adults in the United States, was used to identify the association between mammography screening use and increasing incremental BMI categories, including normal (18.5‐24.9 kg/m2), overweight (25‐29.9 kg/m2), obese class I (30‐34.9 kg/m2), obese class II (35‐39.9 kg/m2), and obese class III (>40 kg/m2), with adjustments for potential confounders. A multivariable logistic regression model was used to evaluate the effect of each BMI category on self‐reported mammography use, using unadjusted and adjusted odds ratios. Effect modification by race/ethnicity was determined by testing interaction terms using Wald tests. Results Of 116,343 survey respondents, 33.5% (38,984 respondents) had a normal BMI, 32.6% (37,969 respondents) were overweight, 19.3% (22,416 respondents) were classified as obese class I, 8.4% (9791 respondents) were classified as obese class II, and 6.2% (7183 respondents) were classified as obese class III. There was no statistically significant difference (P < .05) observed with regard to mammography use between women with a normal BMI and obese women from each obese class (classes I‐III) when compared individually. There also was no evidence of effect modification by race (P = .53). Conclusions In contrast to prior reports, the results of the current study demonstrated no association between obesity and adherence to screening mammography. These findings may relate to the increasing social acceptance of obesity among women from all racial/ethnic groups and the removal of weight‐related facility‐level barriers over time.

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“…Personal embarrassment may be an explanation for the lower attendance at BC screening (Cohen et al, 2008). Studies including black women (Maruthur et al, 2009) and various European surveys (Peytremann-Bridevaux and Santos-Eggimann, 2007;Tekkel et al, 2011;Beeken et al, 2014) did not show a decreased BC screening adherence of overweight and obese women; in some studies, even an increased BC screening attendance was observed in overweight and obese women (Berz et al, 2009;Tekkel et al, 2011;Beckmann et al, 2013). The suspected association between obesity and nonattendance at screening may be confounded by socioeconomic, lifestyle, insurance status, and other factors (Bulliard et al, 2004;Peytremann-Bridevaux and Santos-Eggimann, 2007;Walsh et al, 2011;Vander Weg et al, 2012;Beckmann et al, 2013).…”

Section: Introductionmentioning

confidence: 92%

Overweight, obesity, and breast cancer screening

Eichholzer

Richard

Rohrmann

et al. 2016

European Journal of Cancer Prevention

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Obesity is associated with poor breast cancer (BC) prognosis. Larger tumor size and more advanced disease stage at diagnosis could partly explain this outcome and nonadherence of obese women to BC screening may play a role. We examined the relationship between BMI (kg/m) and the use of mammography in Switzerland as well as separately in the German-speaking part with mainly opportunistic screening and in the French-speaking part with organized programs. We analyzed the data of 50-69-year-old women (n=3121) of the Swiss Health Survey 2012. Study participants were classified as underweight (BMI<18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25-29), or obese (BMI≥30). Outcome measures were dichotomized into 2 years or less since most recent mammography versus more than 2 years or never. We carried out multivariable logistic regression analyses, adjusting for sociodemographics, lifestyle, and self-perceived health. In Switzerland, 47% of women aged 50-69 years had had BC screening within the last 2 years, 35% of women in the German-speaking and 78% of women in the French-speaking part. In the total group, mammography use was higher in overweight than in normal-weight women (adjusted odds ratio 1.21, 95% confidence interval 0.98-1.49). Stratified by region, this effect was only maintained in women of the German-speaking part (adjusted odds ratio 1.41, 95% confidence interval 1.08-1.85; P-interaction<0.001). There were no differences in mammography attendance between normal-weight and obese and underweight women. In the 2012 Swiss Health Survey, overweight, obesity, and underweight were no barriers to mammography. In the German-speaking part, overweight women even attended mammography screening more often than normal-weight women.

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Body mass index and cancer screening: Findings from the English Longitudinal Study of Ageing

Abstract: Severe obesity appears to be a deterrent to CRC screening but not breast cancer screening. Targeted interventions may be required to promote CRC screening uptake in this group, which already has a heightened risk as a consequence of weight.

Cited by 18 publications

References 32 publications

Health and health belief factors associated with screening and help‐seeking behaviours for breast cancer: A systematic review and meta‐analysis of the European evidence

Health and health belief factors associated with screening and help‐seeking behaviours for breast cancer: A systematic review and meta‐analysis of the European evidence

Obesity and breast cancer screening: Cross‐sectional survey results from the behavioral risk factor surveillance system

Overweight, obesity, and breast cancer screening

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