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Obesity and breast cancer screening
Christina C Wee1, Ellen P McCarthy, Roger B Davis
1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. cweekuo@bidmc.harvard.edu
Journal of General Internal Medicine
|April 6, 2004
Summary
Women with obesity have higher breast cancer mortality but lower screening rates. Higher body mass index (BMI) is linked to reduced mammography use in white women, but not black women, indicating racial disparities in screening.
Area of Science:
- Public Health
- Epidemiology
- Health Disparities
Background:
- Women with obesity face higher breast cancer mortality rates.
- Despite this, women with obesity are screened less frequently for breast cancer compared to normal-weight women.
Purpose of the Study:
- To investigate the association between mammography utilization and weight categories.
- To explore how race, illness burden, and other factors influence this relationship.
Main Methods:
- Utilized data from the 1998 National Health Interview Survey, a population-based survey of the U.S. civilian population.
- Included 5,277 women aged 50-75 years who completed relevant questionnaires.
- Assessed mammogram use within the preceding two years.
Main Results:
- Overall, 72% of women reported mammography use; 74% for white women and 70% for black women.
- Among white women, increased body mass index (BMI) correlated with decreased mammography screening (P=.02 for trend).
- In contrast, black women with higher BMI showed similar or increased mammography use compared to normal-weight black women (P for race-BMI interaction =.001).
Conclusions:
- Higher BMI is associated with lower breast cancer screening rates among white women, a disparity not observed in black women.
- These findings persist after adjusting for sociodemographic factors, healthcare access, illness burden, and health habits.
- Further research is essential to understand and address the reasons behind these screening disparities.