Cancer screening among the overweight and obese in Canada.

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
American Journal of Preventive Medicine (Impact Factor: 4.28). 09/2008; 35(2):127-32. DOI: 10.1016/j.amepre.2008.03.031
Source: PubMed

ABSTRACT Despite increased cancer incidence and mortality among overweight and obese men and women, U.S. studies have reported the reduced use of cancer screening among these subjects. We sought to analyze the relationship between overweight/obesity and cancer screening practices using population-based Canadian data.
Responses from adults surveyed in the Canadian Community Health Survey 2003 who provided complete information regarding variables of interest were analyzed. Cancer screening modalities included Pap smear testing, mammography, and fecal occult blood testing, and were based on contemporary recommendations of the Canadian Task Force for Preventive Health. The association between overweight/obesity and cancer screening was explored using logistic regression after adjusting for demographic and socioeconomic factors, health habits, healthcare access, and obesity-related comorbidity. The analysis was conducted in 2007.
Compared to normal-weight controls, overweight and obese women were significantly less likely to have undergone cervical cancer screening. In the fully adjusted model, increasing obesity was associated with decreasing odds of Pap smear testing, with overweight, Class-I, -II, and -III obesity having 95% ORs of 0.87 (0.81, 0.94); 0.79 (0.72, 0.88); 0.62 (0.54, 0.71); and 0.61 (0.53, 0.72), respectively. The prevalence of biennial breast and colorectal cancer screenings was largely unaffected by weight in the adjusted analyses.
Overweight and obesity are associated with markedly lower utilization of cervical cancer screening, despite increased disease risks. This association is independent of sociodemographic factors, comorbidity, and healthcare access. This is consistent with findings in U.S. populations, and suggests that patient and provider factors serve as greater barriers to screening than do healthcare system factors.

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    Journal of Community Medicine & Health Education. 01/2012; 02(03).
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    ABSTRACT: We aimed to disentangle the effects of obesity and mobility limitation on cervical and breast cancer screening among community dwelling women.
    PLoS ONE 08/2014; 9(8):e104901. · 3.53 Impact Factor
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    ABSTRACT: Background: Obesity is a risk factor for cancer incidence and survival, but data on patterns of weight change in cancer survivors are scarce and few stratify by pre-diagnosis weight status. In two population-based cohorts of older adults, we examined weight change in cancer survivors and cancer-free controls in relation to baseline weight status. Methods: In the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS), we identified participants diagnosed with cancer who had pre- and post-diagnosis BMI data (ELSA n = 264; HRS n = 2553), and cancer-free controls (ELSA n = 1538; HRS n = 4946). Repeated-measures ANOVAs tested three-way interactions by group (cancer/control), time (pre-/post-diagnosis), and pre-diagnosis weight status (normal-weight/overweight/obese). Results: Mean BMI change was -0.07 (SD = 2.22) in cancer survivors vs. +0.14 (SD = 1.11) in cancer-free controls in ELSA, and -0.20 (SD = 2.84) vs. +0.11 (SD = 0.93) respectively in HRS. Three-way interactions were significant in both cohorts (ELSA p = .015; HRS p < .001). In ELSA, mean BMI change in normal-weight cancer survivors was +0.19 (SD = 1.53) compared with -0.33 (SD = 3.04) in obese survivors. In ELSA controls, the respective figures were +0.09 (SD = 0.81) and +0.16 (SD = 1.50). In HRS, mean change in normal-weight cancer survivors was +0.07 (SD = 2.30) compared with -0.72 (SD = 3.53) in obese survivors. In HRS controls, the respective figures were +0.003 (SD = 0.66) and +0.27 (SD = 1.27). Conclusion: Over a four-year period, in two cohorts of older adults, cancer survivors lost weight relative to cancer-free controls. However, cancer survivors who were obese pre-diagnosis were more likely to lose weight than healthy-weight survivors or obese adults without a cancer diagnosis. Whether this was due to differences in clinical status or deliberate lifestyle change triggered by the cancer diagnosis is not known. Further research is needed to establish why weight loss occurs more frequently in cancer survivors who were obese at diagnosis, and whether this has favourable effects on mortality.
    BMC Cancer 12/2014; 14:926. · 3.32 Impact Factor