Overweight, obesity, and breast cancer screening

Abstract

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.

Cancer Screening Prevalence and Preference among Hospitalized Women With and Without Obesity

“…In addition, before hospitalization, patients with and without obesity were equally nonadherent to BRC/CRC outpatient screening. This finding was consistent for BRC/CRC screening in larger studies, noting no differences in adherence between women with and without obesity [35][36][37] ; however, past studies have found morbidly obese Whites, low household income, and tobacco use to be risk factors for nonadherence to mammograms. 5,14,15,31 Furthermore, Denberg and colleagues found that lack of scheduled appointments, female sex, and type of insurance predicted nonadherence to screening colonoscopies.…”

Clinicopathologic and Prognostic Significance of Body Mass Index (BMI) among Breast Cancer Patients in Western China: A Retrospective Multicenter Cohort Based on Western China Clinical Cooperation Group (WCCCG)

“…Furthermore, there is another hypothesis that obesity females do less breast screening, and they are more difficult to find small lumps due to too much fatty in breast, so obesity patients tend to have more advanced disease at initial diagnosis [26, 36]. However, a study by Eichholzer et al reported no differences in mammography screening attendance between normal weight and obese and underweight women [38].…”

Long-term prognostic implications of risk factors associated with tumor size: a case study of women regularly attending screening

“…Another important consideration is that our results based on women regularly attending screening suggest that it is especially important for women with high BMI to attend screening. There is mixed evidence from prior studies on the current attendance rate; in some studies women with high BMI were less likely to attend than women with normal BMI while in others there was no significant difference [ 22 , 23 ].…”