Obese women in Canada are less likely to be screened for cervical cancer

Research in the United States has shown that obese people are less likely than their normal-weight peers to undergo screening for breast, colon and cervical cancer. Raj Padwal, Rebecca Mitchell and Scott Klarenbach, from the University of Alberta’s Faculty of Medicine & Dentistry, have undertaken a study to see if this trend is also true in Canada.

"As obesity is associated with higher rates of some types of cancer, it’s important to determine if the presence of obesity influences the use of screening tests," said Padwal.

In 2007 almost 38,000 women participated in a national survey. The women, aged 20-69, were asked questions including:

• their Body Mass Index (to determine the level of obesity)
• whether they have a regular doctor
• did they get breast, colon and cervical cancer screening tests regularly; if so, how often; if not, what are the reasons?

Padwal said for the most part, the results were encouraging. For breast and colon cancer screening the data showed no difference between overweight/obese women and normal-weight women.

But for cervical cancer screening the results were different. While 82 per cent of women said they had a pap smear in the past three years, testing decreased as BMI levels increased. "Obese women are 30 to 40 per cent less likely—depending on the degree of obesity—to have recommended cervical cancer screening performed."

Padwal says the results also showed obese women are two times more likely than normal-weight women to state that fear—including fear of pain, embarrassment or of finding something wrong—was the reason they did not have a pap smear.

"I am reassured that for mammograms and colorectal cancer screening, the presence of obesity doesn’t impact their use, which is different from reports in other countries. However, the gap with pap smears is concerning," he said.

Padwal believes this is an issue that needs to be addressed through increased awareness and vigilance on the part of patients and health care providers. He says more studies are needed to determine if other barriers exist and, if so, what are the best methods of removing those barriers.

(Source: University of Alberta: June 2008)