Cancer screening among the overweight and obese in Canada.
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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ABSTRACT: The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA) testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC) screening, the relationship between weight and screening in men is inconsistent, while there is a trend towards lower CRC screening in higher weight women.Journal of obesity 12/2011; 2011:218250. DOI:10.1155/2011/218250
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ABSTRACT: Perdre du poids est un processus complexe dont l’une des principales difficultés consiste à prévenir l’abandon du traitement. En psychothérapie, plusieurs métaanalyses ont démontré l’influence de l’alliance thérapeutique sur l’abandon des traitements, quels qu’ils soient. Or, dans le traitement de l’obésité, peu d’études se sont intéressées à cette variable. En s’appuyant sur des études empiriques, cet article vise à décrire et à analyser des facteurs personnels et interpersonnels qui complexifient l’établissement et le maintien, dans le traitement de l’obésité, d’une alliance thérapeutique optimale.Obésité 09/2012; 7(3). DOI:10.1007/s11690-012-0340-y