Adherence to breast and cervical cancer screening guidelines according to obesity status: a French cross-sectional...

To assess breast and cervical cancer screening rates among women according to body mass index (BMI).

This cross-sectional study used anonymous self-administered questionnaires given to women from three French university hospitals with normal weight (BMI 18.5-25 kg/m²), class I obesity (BMI 30-35 kg/m²), or class II obesity (BMI ≥ 35 kg/m²) in 2020-2021. Up-to-date screening was defined according to national guidelines: biennial clinical breast exams and mammograms for women aged 50-74, and triennial cervical samples for women aged 25-65, excluding those with prior cancer or related surgery. Screening rates and gynecological follow-up were compared across BMI groups.

Among 439 women (20% class I, 22% class II obesity), 178 and 370 were eligible for breast and cervical cancer screening, respectively. Women with class I and II obesity were less likely to be up-to-date for clinical breast exams (Odds Ratio [95% confidence interval] 2.35[1.06,5.20] and 2.68[1.12,6.42], respectively), mammography (4.43[1.49,13.18] and 4.08[1.22,13.62]), and cervical samples (2.23[1.09,4.54] and 2.85[1.42,5.72]). Class II obesity was associated with more frequent follow-up by general practitioners (p < 0.05).

Women with obesity are less likely to receive recommended gynecological cancer screenings than normal-weight peers. These disparities call for more inclusive healthcare strategies.Trial registration: NCT04357652.