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Women's Health

Weight Comes Between Women and Cancer Screenings

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May 1, 2000 -- For overweight and obese women, there's a double jeopardy in screening for cancer of the breast and cervix. These women have an increased risk of getting these cancers. Yet they are less likely to have the recommended screenings -- mammography and Pap smears -- than women of normal weight.

The authors of a recent study suggest that physicians' negative attitudes toward these patients may mean they are offered screening less frequently. Also, the patients' own poor self-perceptions may keep them from seeking preventive care, the authors write in a study published in the journal Annals of Internal Medicine.

"We can only speculate on the reasons for this discrepancy," researcher Christina C. Wee, MD, MPH, tells WebMD. "Because both of these tests are personal, patients' poor self-esteem may affect their willingness to come in." Wee cautioned that the study might have some inaccuracies because the information was self-reported. She is an instructor at Harvard Medical School in Boston and a general internist at Beth Israel Deaconess Medical Center.

Among almost 8,400 women 18 to 75 years old who had not had a hysterectomy, 78% of overweight women and 78% of obese women had received Pap smears in the previous three years. Among women of normal weight, 85% had Pap smears during that time.

The investigators observed a similar pattern for mammography to screen for breast cancer. Of the women who were eligible for mammography and for whom height and weight data were available, 65% overall had been screened in the past two years. The rate was 64% for overweight women and 62% for obese women, while for women of normal weight, the mammography rate was 68%.

Because obesity has fewer stigmas in black culture, the authors wanted to see if these differences in screening held true in black women. For these women, excess weight and obesity "was not a significant correlate of Pap smear screening in any weight category," the researchers write. They found similar results for mammography.

"These findings raise concern that obesity may be an unrecognized barrier to preventive care," the researchers write. "Because overweight and obese women are at increased risk for death from breast and cervical cancer, they should be targeted for increased screening."

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