Relationship Between Body Mass Index and Prostate Cancer Screening in the United States

Department of Surgery, Duke University, Durham, North Carolina, United States
The Journal of Urology (Impact Factor: 4.47). 03/2007; 177(2):493-8. DOI: 10.1016/j.juro.2006.09.059
Source: PubMed


Obesity is associated with more advanced disease and worse outcomes in men with prostate cancer. To our knowledge the relationship between obesity and prostate cancer screening behavior in men 40 or older is unknown. Thus, we examined associations between body mass index and prostate cancer screening behavior.
We used the 2002 Behavioral Risk Factor Surveillance System to study prostate cancer screening in a representative sample of 57,827 men 40 years or older. Primary outcomes were the proportion of men ever screened and the proportion screened in the last year for prostate cancer.
Obese men were more likely than normal weight men to have had a prostate specific antigen test (62.1% vs 56.1%, p <0.001) and to have had a prostate specific antigen test in the last year (44.2% vs 38.2%, p <0.001). After controlling for sociodemographic characteristics obese men remained more likely than normal weight men to have had a prostate specific antigen test (OR 1.46, 95% CI 1.33-1.61) and to have had a prostate specific antigen test in the last year (OR 1.42, 95% CI 1.30-1.55). Respondents reporting an ongoing relationship with a physician (OR 2.88, 95% CI 2.57-3.22) and black nonHispanic men vs white men (OR 1.58, 95% CI 1.38-1.81) were also more likely to have had a prostate specific antigen test in the last year.
Obese men are more likely than normal weight men to be screened for prostate cancer. Associations between advanced stage, worse outcomes and obesity may not be explained by disparities in the screening of obese men for prostate cancer.

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    • "A report from the Centers for Disease Control and Prevention indicated that 33.8% of adults in the US are obese [16]. While a number of previous studies reported the association between obesity and cancer screening rates in other cancers like breast [17], cervical [10], prostate cancer [18], and colorectal cancer [11], very few studies used national level survey data. Contradicting findings indicating that obese adults were less likely to be screened for colorectal cancer were also reported [7–9], but previously published studies used various types of data source, methodology, age of the study population, and clinical setting. "
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    ABSTRACT: Background. Findings from previous studies on an association between obesity and colorectal cancer (CRC) screening are inconsistent and very few studies have utilized national level databases in the United States (US). Methods. A cross-sectional study was conducted using data from the 2005 Medicare Current Beneficiary Survey to describe CRC screening rate by obesity status. Results. Of a 15,769 Medicare beneficiaries sample aged 50 years and older reflecting 39 million Medicare beneficiaries in the United States, 25% were classified as obese, consisting of 22.4% “obese” (30 ≤ body mass index (BMI) < 35) and 3.1% “morbidly obese” (BMI ≥ 35) beneficiaries. Almost 38% of the beneficiaries had a body mass index level equivalent to overweight (25 ≤ BMI < 30). Of the study population, 65.3% reported having CRC screening (fecal occult blood testing or colonoscopy). Medicare beneficiaries classified as “obese” had greater odds of CRC screening compared to “nonobese” beneficiaries after controlling for other covariates (ORadj = 1.25; 95% CI: 1.12–1.39). Conclusions. Findings indicate that obesity was not a barrier but rather an assisting factor to CRC screening among Medicare beneficiaries. Future studies are needed to evaluate physicians' ordering of screening tests compared to screening claims among Medicare beneficiaries to better understand patterns of patients' and doctors' adherence to national CRC screening guidelines.
    Full-text · Article · Apr 2013 · Journal of obesity
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    • "Four studies examined the association between obesity and prostate cancer screening, and all used prostate-specific antigen (PSA) testing as their outcome. Three of the four studies indicated that obese men were more likely to have had a PSA test [9] [10] [11] when compared with their normal-weight peers. One study examined obesity and PSA testing in a cohort of men from primary care practices and found a consistent association with obesity and increased PSA testing, regardless of race [10] "
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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.
    Full-text · Article · Dec 2011 · Journal of obesity

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