Cancer Screening in WomenBody Mass Index and Adherence to Physician Recommendations

Abstract

Objectives-Reasons obese women are less likely to obtain mammograms and Pap smears are poorly understood. This study evaluated associations between body mass index (BMI) and receipt of and adherence to physician recommendations for mammography and Pap smear. Results-After adjusting for sociodemographic variables, health care access, health behaviors, and comorbidity, severely obese women (BMI ≥ 40 kg/m 2 ) were less likely to have mammography within 2 years (OR 0.50; 95% CI 0.37, 0.68) and Pap smear within 3 years (OR, 0.43; 95% CI, 0.27,0.70). Obese women were as likely as normal weight women to receive physician recommendations for mammography and Pap smear. Severely obese women were less likely to adhere to physician recommendation for mammography (OR 0.49; 95% CI,. Women in all obese categories (BMI ≥ 30 kg/m 2 ) were less likely to adhere to physician recommendation for Pap smear (OR's ranged 0.17-0.28; p<0.001). Methods-DataConclusions-Obese women are less likely to adhere to physician recommendations for breast and cervical cancer screening. Interventions focusing solely on increasing physician recommendations for mammography and Pap smears will probably be insufficient for obese women. Additional strategies are needed to make cancer screening more acceptable for this high-risk group.

Diabetes and Cancer Screening Rates among Appalachian and Non-Appalachian Residents of Kentucky

“…This theory is consistent with studies by Ferrante et al 27 indicating that obese women are less likely to adhere to mammography recommendations. It may be that obese women are more selfconscious in the situation of exposing their breasts to multiple strangers at a radiology suite, a hypothesis consistent with the research of Wee et al 28 and Amy et al 29 In addition, mammography may be more technically difficult, painful, or unpleasant for obese women.…”

Intimate Partner Violence and Cancer Screening among Urban Minority Women

“…11,15,19,20 The majority of studies assume linear relationships between IPV and cancer screening rates. [15][16][17] However, further exploration of our data suggests that nonlinear relationships may also exist.…”

“…Variables significantly associated with each outcome and IPV at the P Ͻ .05 level were noted for greater parsimony. 11,19 We did not include any practice-level variables to control for clustering effect because detailed information about the practices was not collected. In addition, the small group size of the residency practice (n Ͻ 50) and its lack of variation on victim status may generate biased estimates when conducting multilevel analysis.…”

“…1,[7][8][9][10][11]13,15,19,20,29,31 Demographic factors included age (21 to 29 years, 40 to 49 years, 50 to 64 years, and 65 to 74 years); race/ethnicity (white, African American, Hispanic, other); education level (Յhigh school, some college, college completed); employment status (employed or unemployed); insurance type (commercial, Medicaid/Medicare, other); and marital status (married or unmarried). Health risk behavior included smoking status (ever a smoker or never a smoker); drug use within the past year (yes or no); and alcohol use within the past year (yes or no).…”

“…18 Physical health status, such as comorbidity and obesity, have been found to be barriers to cancer screening among minority women. 19,20 However, the effect of social influences as barriers to cancer screening remains largely unexamined. Studies have suggested that IPV is a risk factor for medical noncompliance.…”