157693 Is the prevalence of cervical cancer screening lower among obese women?

Monday, November 5, 2007: 8:50 AM

Fatma Shebl, MD, MS, MHS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Katayoun Khosravani, MD, MS , Maryland Department of Health and Mental Hygiene, Baltimore, MD
Toumany Coulibaly, MD, MS , Institute of Human Virology, University of Maryland, Baltimore, Baltimore, MD
Min Zhan, PhD , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Pat Langenberg, PhD , Department of Epidemiology & Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
Diane M. Dwyer, MD , Medical Director Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Carmela Groves, RN MS , Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Annette Hopkins, RN MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Eileen K. Steinberger, MD MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
        
Background: Death from cervical cancer is preventable with routine Pap test screening. There is evidence screening may decrease with increasing BMI. Methods: The Maryland Cancer Survey, conducted in 2004, was a population-based telephone survey examining cancer screening rates and risk behaviors. Prevalence of Pap testing in the last 3 years was compared at different levels of BMI (weighted percents). Logistic regression was used to describe the association of BMI with Pap testing, adjusted for possible covariates. Results: Of 1526 women in our sample who were age 40 to 64 years old and without a hysterectomy, 26.2% were obese, 29.9% were overweight, and 43.9% were under/normal weight. 92.3% reported having a Pap smear within the past three years. White and African American women were more likely to have a recent pap (93.1% and 91.5%) than women of other races (84.7%, P value<0.049). Among all women, those who were obese had 2.45 increased odds of NOT having a Pap smear in the last 3 years compared to women who were not obese (BMI < 30 kg/m2). This difference between obese and non-obese, was seen only among white women (OR = 3.57, 95% CI 2.65-4.79), and not among minority women (OR = 1.01, 95% CI 0.48-2.14). Conclusion: In Maryland, obese white women are less likely to have Pap testing compared to non-obese white women. This difference was not seen among minority women. Efforts are needed to increase routine Pap testing among all women, with emphasis on those who are obese.

Learning Objectives:
1. Describe the recommendations for Pap smear screening for cervical cancer. 2. Assess the prevalence of Pap smear screening in Maryland among women 40-64 years of age. 3. Identify possible differences in screening by body mass index and race.

Keywords: Cervical Cancer, Cancer Screening

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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