Race and ethnicity has been shown to be a modifying factor in associations between obesity and cancer screening among women. In a new study, researchers aimed to update information and evidence for association of different personal characteristics and cancer screening disparities and found that obesity, as determined by BMI, is not a factor that influences the screening compliance differences among different races/ethnicities. The research article, entitled “Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women,” was published in the Journal of Women’s Health.
Several studies have focused on the association between race/ethnicity and cancer screening adherence, due to observations that suggest that increased cancer mortality in minority women is the result of cancer screening disparities. In particular, black women present higher breast cancer mortality, suggested to be caused by lower use of mammograms and/or lack of follow-up consultations, and cervical cancer screening through Papanicolaou (Pap) testing has been found to be less used in Hispanic women, who experience increased incidence and mortality from cervical cancer. Different studies suggest that these and other minorities’ behaviors can be attributed to causes that affect women’s health monitoring in different ways according to their age/ethnicity, such as lower knowledge, need to reschedule appointments, lack of provider recommendation and lack of insurance. In particular, obesity has been found to be associated with reduced cancer screening and this screening is especially important in obese women, since this condition is a risk factor for the development of breast and cervical cancer. The relationship between obesity and cancer screening, specially breast cancer screening, is still unclear.
With the objective of comparing and evaluating how different characteristics, including body mass index (BMI), affect the association of race/ethnicity with cervical and breast cancer screening, researchers used up-to-date data from the Health Information National Trends Survey (HINTS) to verify associations between BMIs and cancer screening, stratified by race/ethnicity. Furthermore, the association of age, income and insurance status was also evaluated in cancer testing compliance among different racial/ethnic groups. The study included 4992 women who were evaluated for Pap testing and 3773 for mammography.
Results show that many of the disparities in cancer screening found in previous studies remain true, but seem to be decreasing. Researchers found that higher household income among white women resulted in higher probability of having a Pap test or mammogram. Increased likelihood of having the Pap screening test was found among white and black women with insurance. The likelihood of having a mammogram was higher only in insured white and Hispanic women. No notable variation was found between racial/ethic groups according to their status as underweight, normal weight, overweight, or obese and their probability of having the screening tests. However, one significant particular association was found. Black women with BMIs between 25 and 30, classified as overweight, were less likely to receive a Pap test than black women with BMIs <25, classified as normal or underweight.
The study of compliance trends to screening tests among women are of great importance for the prevention and fight against avoidable cancer deaths, as it leads to the identification of specific target areas to improve awareness and facilitate access to testing. “This study adds to our understanding of variations in compliance with cancer screening guidelines among racial/ethnic groups,” sated Dr Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women’s Health in a press release.