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The association between obesity and screening mammography accuracy
Joann G Elmore1, Patricia A Carney, Linn A Abraham
1Division of General Internal Medicine, University of Washington School of Medicine, Harborview Medical Center, 325 Ninth Avenue, Box 359780, Seattle, WA 98104-2499, USA. jelmore@u.washington.edu
Archives of Internal Medicine
|May 26, 2004
Summary
Obese women face a higher risk of false-positive mammography results. Maintaining a normal body mass index may improve screening mammography accuracy for women.
Area of Science:
- Radiology
- Public Health
- Women's Health
Background:
- Rising obesity rates in American women, particularly older women.
- Limited research on obesity's impact on screening mammography accuracy.
Purpose of the Study:
- To investigate the relationship between body mass index (BMI) and screening mammography accuracy.
- To assess how different BMI categories affect mammogram recall rates and specificity.
Main Methods:
- Analysis of 100,622 screening mammograms from a non-profit health plan.
- Categorization of BMI into underweight/normal (<25), overweight (25-29), obesity class I (30-34), and obesity classes II-III (≥35).
- Statistical analysis including odds ratios (OR), confidence intervals (CI), and receiver operating characteristic (ROC) curves.
Main Results:
- Obese women had a significantly higher likelihood of recall for additional testing compared to normal weight women (ORs ranging from 1.17 to 1.31).
- Increased BMI correlated with decreased specificity, indicating more false positives (ORs ranging from 0.77 to 0.86).
- No significant difference in sensitivity was observed across BMI categories.
Conclusions:
- Obesity is associated with an increased risk of false-positive mammography results, but not reduced sensitivity.
- Achieving a normal weight may enhance the performance of screening mammography in women.