Researchers from the Harvard-affiliated Beth Israel Deaconess Medical Center surveyed 11,435 women to determine whether being overweight is associated with lower reported rates of screening with Pap smears and mammography.
Pap smears involve the collection of cells around the cervix and are used to detect irregularities that may indicate cervical cancer. Mammograms find breast abnormalities that may be cancerous by taking an X-ray of the breast. According to medical guidelines, Pap smears should be performed annually in sexually active women or in women age 18 or older, and mammograms should be performed yearly in women over the age of 40. Both screening methods can detect cancers at an early, more treatable stage.
Previous studies have also shown that obese women receive fewer medical services to prevent disease than do non-obese women.
78% of obese and overweight women aged 17 to 74 reported having had a Pap smear in the previous 3 years, compared with 84 percent of normal-weight women of the same ages. In women aged 50 to 75, 64 percent of overweight women and 62 percent of obese women had received mammograms in the previous 2 years. In contrast, 68 percent of normal-weight women in this age group reported having been screened for mammograms.
Compared to women who are not overweight, obese women face higher rates of death from breast and cervical cancer. Obesity is also associated with an increased risk of dying from cardiovascular disease, including heart disease and stroke.
“It’s my feeling that women who are overweight and obese have lower self-esteem and poor self-image, which may influence their decisions,” said the study’s lead author, Christina C. Wee, M.D., M.P.H.
Wee suggested that these factors might make women more reluctant to undergo screening procedures. Wee also hypothesized that the constraints of the current healthcare system may limit the time doctors can spend counseling patients on the importance of breast and cervical cancer screening.
“I hope that as the results of this study are publicized and as awareness about this disparity is raised,” Wee said, “physicians will spend more time making sure that women, especially overweight women, are informed about the benefits of screening.”
An editorial accompanying Wee’s report expressed some criticism of the study and cautioned against over-interpreting the findings.
“The study by Wee and colleagues must be confirmed in other patient groups by using methods other than self-report,” said Dr. Russell Harris, M.D., M.P.H. of the University of North Carolina School of Medicine. He emphasized the need for effective communication between patients and their physicians.
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Tags: abnormalities, mammography, overweight