Cancer Causes & Control

, Volume 18, Issue 7, pp 765–773

Obesity and recent mammography use among black and white women in the Southern Community Cohort Study (United States)

  • Sarah S. Cohen
  • Lisa B. Signorello
  • Marilie D. Gammon
  • William J. Blot
Original Paper

Abstract

Objective

To examine the relationship between obesity and mammography use in a large population of black and white women.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Mammogram Obesity Body mass index Race Epidemiology 

References

  1. 1.
    American Cancer Society (2006) Cancer Facts & Figures 2006. American Cancer Society, AtlantaGoogle Scholar
  2. 2.
    Humphrey LL, Helfand M, Chan BKS, Woolf SH (2002) Breast cancer screening: a summary of the evidence for the U.S. Preventive services task force. Ann Intern Med 137:347–360PubMedGoogle Scholar
  3. 3.
    Olsen O, Gøtzsche PC (2001) Screening for breast cancer with mammography. Cochrane Database Syst Rev 4:CD001877PubMedGoogle Scholar
  4. 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
  5. 5.
    Wee CC, McCarthy EP, Davis RB, Phillips RS (2000) Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care? Ann Intern Med 132:697–704PubMedGoogle Scholar
  6. 6.
    Wee CC, McCarthy EP, Davis RB, Phillips RS (2004) Obesity and breast cancer screening, the influence of race, illness burden, and other factors. J Gen Intern Med 19:324–331PubMedCrossRefGoogle Scholar
  7. 7.
    Zhu K, Wu H, Jatoi I, Potter J, Shriver C (2006) Body mass index and use of mammography screening in the United States. Prev Med 42:381–385PubMedCrossRefGoogle Scholar
  8. 8.
    Fontaine KR, Heo M, Allison DB (2001) Body weight and Cancer Screening among Women. J Womens Health Gend Based Med 10:463–470PubMedCrossRefGoogle Scholar
  9. 9.
    Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723–1727PubMedCrossRefGoogle Scholar
  10. 10.
    Signorello LB, Hargreaves MK, Steinwandel MD et al (2005) The Southern Community Cohort Study: establishing a cohort to investigate health disparities. J Natl Med Assoc 97:972–979PubMedGoogle Scholar
  11. 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. 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. 13.
    Hosmer DW, Lemeshow S (1989) Applied logistic regression. John Wiley & Sons, Inc., New York, NYGoogle Scholar
  14. 14.
    Andresen EM, Maligner JA, Carter WB, Patrick DL (1994) Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med 10:77–84PubMedGoogle Scholar
  15. 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
  16. 16.
    Carmichael AR, Bates T (2004) Obesity and breast cancer: a review of the literature. Breast 13:85–92PubMedCrossRefGoogle Scholar
  17. 17.
    Key TJ, Verkasalo PK, Banks E (2001) Epidemiology of breast cancer. Lancet Oncol 2:133–140PubMedCrossRefGoogle Scholar
  18. 18.
    Stephenson GD, Rose DP (2003) Breast cancer and obesity: an update. Nutr Cancer 45:1–16PubMedCrossRefGoogle Scholar
  19. 19.
    McTiernan A, Gilligan MA, Redmond C (1997) Assessing individual risk for breast cancer: risky business. J Clin Epidemiol 50:547–556PubMedCrossRefGoogle Scholar
  20. 20.
    Abrahamson PE, Gammon MD, Lund MJ et al (2006) General and abdominal obesity and survival among young women with breast cancer. Cancer Epidemiol Biomarkers Prev 15:1871–1877PubMedCrossRefGoogle Scholar
  21. 21.
    Anderson LA, Eyler AA, Galuska DA, Brown DR, Brownson RC (2002) Relationship of satisfaction with body size and trying to lose weight in a national survey of overweight and obese women aged 40 and older. Prev Med 35:390–396PubMedCrossRefGoogle Scholar
  22. 22.
    Fitzgibbon ML, Blackman LR, Avellone ME (2000) The relationship between body image discrepancy and body mass index across ethnic groups. Obes Res 8:582–589PubMedCrossRefGoogle Scholar
  23. 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
  24. 24.
    Coughlin SC, Uhler RJ, Bobo JK, Caplan L (2004) Breast cancer screening practices among women in the United States, 2000. Cancer Causes Control 15:159–170PubMedCrossRefGoogle Scholar
  25. 25.
    Rowland ML (1990). Self-reported weight and height. Am J Clin Nutr 52:1125–1133PubMedGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Sarah S. Cohen
    • 1
    • 2
  • Lisa B. Signorello
    • 1
    • 3
    • 4
  • Marilie D. Gammon
    • 2
  • William J. Blot
    • 1
    • 3
    • 4
  1. 1.International Epidemiology InstituteRockvilleUSA
  2. 2.Department of EpidemiologyUniversity of North CarolinaChapel HillUSA
  3. 3.Department of MedicineVanderbilt UniversityNashvilleUSA
  4. 4.Vanderbilt-Ingram Cancer CenterNashvilleUSA

Personalised recommendations