Obesity and recent mammography use among black and white women in the Southern Community Cohort Study (United States)
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To examine the relationship between obesity and mammography use in a large population of black and white women.
Baseline data from 18,756 black and 6,304 white women enrolled in the Southern Community Cohort Study were used to examine the association between body mass index categories (healthy weight: 18.5–24.9 kg/m2, overweight: 25–29.9 kg/m2, and obesity classes I: 30–34.9 kg/m2, II: 35–39.9 kg/m2, and III: 40+ kg/m2) and mammogram use in the past two years. Cross-sectional analyses were conducted using logistic regression controlling for socioeconomic measures, medical conditions, insurance coverage, and lifestyle factors.
Among white women, obesity class III was associated with a reduced likelihood of recent mammography compared to healthy weight women (OR = 0.70, 95% CI 0.56–0.87) that appeared unrelated to income and insurance coverage. A deterring effect of obesity was not evident among black women; instead, overweight and obesity were associated with small elevations in mammography use compared to healthy weight.
In light of rising obesity rates and known associations between obesity and breast cancer risk and prognosis, a deterring effect of extreme obesity on mammography screening for white women is a concern that should be addressed by screening programs and by further directed research into the factors underlying this association.
KeywordsMammogram Obesity Body mass index Race Epidemiology
We thank Michael T. Mumma for geo-coding the Community Health Centers and providing a link to the corresponding US Census data. We would also like to thank Heather M. Munro for her statistical review during the preparation of this manuscript. Financial Support: The Southern Community Cohort Study is supported by grant R01 CA92447 from the National Cancer Institute.
- 1.American Cancer Society (2006) Cancer Facts & Figures 2006. American Cancer Society, AtlantaGoogle Scholar
- 4.U.S. Preventive Services Task Force (2002) Screening for breast cancer: recommendations and rationale. Agency for Healthcare Research and Quality, Rockville, MD http://www.ahrq.gov/clinic/3rduspstf/breastcancer/brcanrr.htm
- 11.Hargreaves M, Arnold C, Blot WJ (2006) Community health centers: their role in the treatment of minorities and in health disparities research. In: Satcher D, Pamies R (eds) Multicultural medicine and health disparities. McGraw-Hill, New York, NY, pp 485–494Google Scholar
- 12.Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults (1998) Arch Int Med 158:1855–1867Google Scholar
- 13.Hosmer DW, Lemeshow S (1989) Applied logistic regression. John Wiley & Sons, Inc., New York, NYGoogle Scholar
- 15.Ostbye T, Taylor DH Jr, Yancy WS Jr, Krause KM (2005) Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the health and retirement study (HRS) and the asset and health dynamics among the oldest old (AHEAD) study. Am J Public Health 95:1623–1630PubMedCrossRefGoogle Scholar
- 23.Centers for Disease Control and Prevention (CDC) (2004) Behavioral risk factor surveillance system survey data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, Georgia, 5 September 2006. http://apps.nccd.cdc.gov/brfss/display.asp?yr=2004&cat=WH&qkey=4421&state=US