Severe obesity associated with reduced prevalence of cancer screenings

In a recent cross-sectional study, researchers from Pennington Biomedical Research Center found that severe obesity is associated with a lower rate of cancer screenings, which the researchers said could possibly be due to greater health care engagement and fewer barriers.

In their study, the researchers analysed de-identified data from the Behavioral Risk Factor Surveillance System to reach these findings. While rates of cancer screenings varied among the various BMI groups and the various types of cancer screenings, screening rates for Papanicolaou testing, mammography, sigmoidoscopy and colonoscopy among those in the 50 or greater BMI group saw a significant reduction compared to the base groups.

“Our study identifies a crucial gap in recommended cancer screenings for those with severe obesity,” said Dr Vance Albaugh, Assistant Professor of Metabolic Surgery at Pennington Biomedical and the Metamor Institute. “From accessibility issues to technical limitations, the current state of the broader health care system presents hurdles that discourage participation among higher BMI groups for these screenings. Participation in home-based tests indicates some promise, but many of these self-administered screenings are only truly effective with an inpatient follow-up, such as a colonoscopy.”

Excluding profiles that did not include body mass index information, the researchers evaluated more than 2 million profiles in the surveillance data, categorizing them into five BMI groups: 30 to 34.9, 35 to 39.9, 40 to 49.0, more than 50, and the range of 18.5 to 29.9 used as a reference. The cancer screenings the researchers examined included colon and rectal, cervical, breast, and prostate cancer – all of which are routinely recommended by the US Prevent Services Task Force.

In contrast to the 50 and greater BMI category, other BMI categories associated with higher rates of obesity, such as BMI in the 30 to 39.9 range, show comparable or slightly higher screening rates than the reference, possibly due to greater health care engagement and fewer barriers.

“The findings in this research highlight the need to make cancer screening more accessible and effective for people with severe obesity,” said Dr John Kirwan, Executive Director of Pennington Biomedical. “With further research, we can reach a better understanding of the barriers for this population, and we can help ensure that every patient receives the preventive care they need to detect cancer early and improve outcomes. I commend our researchers for this comprehensive understanding of these screening trends.”

The findings were reported in a Research letter, 'Obesity Severity and Cancer Screening in US Adults', published in JAMA Open. To access the letter, please click here