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White women who suffer from obesity are less likely to undergo Pap testing for cervical cancer

Obesity is associated with a higher risk of cancer death, including death from cervical cancer. A study supported in part by the Agency for Healthcare Research and Quality (HS11683) indicates that white women who are obese are more likely than women of normal weight to delay Pap testing to screen for cervical cancer or to find it painful, uncomfortable, or embarrassing.

Christina C. Wee, M.D., M.P.H., and colleagues at Beth Israel Deaconess Medical Center and Harvard Medical School examined Pap testing in the preceding 3 years for 6,419 white, 1,715 black, and 1,859 Hispanic women aged 18 to 75 years, who responded to the 2000 National Health Interview Survey supplemental Cancer Control Module. They analyzed women's reasons for not undergoing Pap testing and the impact of body mass index (BMI), and examined whether unscreened women received physician recommendations for screening.

Overall, 86 percent of white, 88 percent of black, and 78 percent of Hispanic women reported Pap testing in the last 3 years. After adjustment for sociodemographic factors, health care access, and illness burden, white women who suffered from severe obesity (a BMI of 40+) were 9 percent less likely to undergo Pap testing compared with white women of normal weight. BMI was not associated with screening in black or Hispanic women.

Among all women who had seen a gynecologist or general practitioner in the previous year, those suffering from obesity were as likely as those who were normal weight to receive a recommendation from their physician for Pap testing. Although not the most common reason cited, white women who were obese were more likely than normal or overweight white women to report "discomfort and embarrassment" as a reason for not undergoing screening.

See "BMI and cervical cancer screening among white, African-American, and Hispanic women in the United States," by Dr. Wee, Russell S. Phillips, M.D., and Ellen P. McCarthy, Ph.D., M.P.H., in the July 2005 Obesity Research 13(7), pp. 1275-1280.

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