Challenges Associated With Cervical Cancer Screening and Management in Obese Women: A Provider Perspective

Area of Science:

• Gynecology
• Oncology
• Public Health

Background:

• Obesity increases cervical cancer risk, partly due to missed precancer detection during screening.
• Effective cervical cancer screening and management in obese women present unique challenges.

Purpose of the Study:

• To understand clinician-reported challenges in performing cervical cancer screening and management in obese women.
• To identify potential solutions and improvements for screening obese women.

Main Methods:

• A web-based survey was administered to 2,319 members of the American Society of Colposcopy and Cervical Pathology.
• Survey focused on challenges in cervical sampling, visualization, and biopsy in obese versus normal-weight women.
• Descriptive statistics and Fisher exact tests were used to analyze provider responses.

Main Results:

• 89% found cervical sampling and 93% visualization more challenging in obese women.
• Common barriers included vaginal prolapse, visualization/access difficulties, and inadequate equipment size.
• Lack of specific training was identified as a significant learning gap, with only 8% reporting prior training.

Conclusions:

• Cervical cancer screening and management are significantly more challenging in obese women.
• Inadequate equipment size and insufficient education/training are major barriers.
• Addressing these barriers is crucial for improving screening and management in this population.