Women who are significantly overweight have higher death rates from cancers of the breast and cervix than thinner women. The reason for this discrepancy may be explained, in part, by the recent findings of researchers from Boston, who reported that overweight women receive less frequent screening, with mammography and Pap smears, for these cancers.
Cancers of the breast and cervix are 2 types of cancer that can be successfully treated in many cases, if detected early. For this reason, screening for these cancers is important. The term
screening refers to the regular use of certain examinations or sensitive tests in persons who do not have any symptoms of a cancer (referred to as being
asymptomatic) but are at an increased risk for a cancer. The American Cancer Society screening guidelines for cancer of the breast indicate that asymptomatic women who are 40 years of age or older should undergo an annual
mammogram (special type of x-ray of the breast), annual clinical breast examination at the doctor’s office, and monthly breast self-examination, while asymptomatic women who are 20 to 39 years of age should undergo a clinical breast examination at the doctor’s office every 3 years and breast self-examination every month. For screening for cancer of the cervix, the American Cancer Society recommends that women who are sexually active or are age 18 years or older receive an annual pelvic examination and
Pap smear, a procedure in which tissue is scraped from the cervix area and then examined under a microscope for abnormal cells. Then, after 3 years of normal Pap smear and pelvic examination results, less frequent Pap smears may be appropriate if so determined by the woman’s physician. Because those who are significantly overweight (sometimes clinically referred to as
obese) die from cancers of the breast and cervix than do those who are thinner, researchers recently compared the screening practices of these 2 groups of women.
Researchers from the Beth Israel Medical Center in Boston surveyed 11,435 women to determine any relationship between being overweight (or significantly overweight) and receiving mammograms and/or Pap smears. They found that, of women 18 to 75 years old, 84% who were of normal weight and only 78% who were overweight and significantly overweight underwent a Pap smear in the previous year. Of women age 50 to 75 years, 68% who were of normal weight, 64% who were overweight, and 62% who were significantly overweight had a mammogram in the previous 2 years. In fact, the results showed that overweight and significantly overweight women had mammograms and Pap smears less frequently than thinner women, even after the statistics were adjusted for other factors that might prevent the women from receiving this care.
These findings suggest that women who are significantly overweight are not only more likely to die from their breast or cervical cancer, but less likely to receive screening for these cancers. For these reasons, doctors should encourage women who are overweight to undergo the recommended screening measures to ensure that any breast or cervical cancers are detected early and treated effectively. Women who are overweight and in need of screening for breast and cervical cancers may wish to talk with their doctor about the benefits of such screening and ways to help make the procedures more comfortable for them. (Annals of Internal Medicine, Vol 132, No 9, pp 697-704, 2000)
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