Severe Obesity in Cancer Care

Area of Science:

• Oncology
• Public Health
• Medical Imaging

Background:

• Obesity is a growing global health concern with significant implications for cancer care.
• Excess body fat and increased body mass index (BMI) can impede cancer detection, diagnosis, and treatment.
• Specific challenges exist in screening and staging for gynecological cancers in obese individuals.

Purpose of the Study:

• To investigate the impact of obesity on cancer screening participation and diagnostic procedures.
• To examine the relationship between high BMI and the completeness of surgical staging for endometrial cancer.
• To identify barriers contributing to the underuse of cancer screening and adequate staging in obese patients.

Main Methods:

• Retrospective review of 324 primary surgical patients.
• Analysis of screening practices and surgical staging completion rates stratified by BMI.
• Qualitative assessment of barriers to care, including patient and provider factors.

Main Results:

• Obese women show reduced engagement in breast and cervical cancer screenings.
• Patients with a BMI > 35 kg/m2 experience difficulties with physical and internal pelvic examinations.
• Individuals with a BMI > 40 kg/m2 were seven times less likely to complete surgical staging for endometrial cancer.

Conclusions:

• Obesity presents significant challenges to effective cancer screening and staging, particularly for gynecological cancers.
• Healthcare provider bias and patient-related factors (embarrassment, fear) create substantial barriers to addressing obesity in clinical settings.
• Improved strategies are needed to overcome these obstacles and ensure equitable cancer care for obese individuals.