197170 Is obesity a barrier to cervical cancer screening among women in California?

Sunday, November 8, 2009

Nicole Wojtal , UCB-UCSF Joint Medical Program, University of California, Berkeley, Berkeley, CA
Sharon Jotblad , School of Public Health, University of California, Berkeley, Berkeley, CA
Patricia Lee, PhD , Office of Women's Health, Department of Health Care Services, Sacramento, CA
Nana Tufuoh, MD, MPH , Cancer Detection Section, California Department of Public Health, Sacramento, CA
Stan Sciortino, MPH, PhD , Cancer Detection Section, California Department of Public Health, Sacramento, CA
Sharon Sugerman, MS, RD , Cancer Control Branch, Network for a Healthy California, California Department of Public Health, Sacramento, CA
Heidi Bauer, MD, MS, MPH , STD Control Branch, California Department of Public Health, Richmond, CA
  
Women who are most at risk for cervical cancer are those who have never or rarely been screened for the disease. Recent studies have demonstrated an association between higher body mass index (BMI), a measure of obesity, and less frequent receipt of preventive services. To determine whether BMI is associated with reported cervical cancer screening among women in California, we analyzed data from the 2007 California Women's Health Survey (CWHS), limited to women ages 25-65 years (N=3253, weighted) for whom Pap testing is uncontroversial. Overall, 5.8% of women reported never having had a Pap test or not having had a Pap test within the last 5 years. Among women with a BMI of <18.5 (kg/m2), 1.6% were rarely or never screened, compared with 4.9% among women with a BMI from 18.5 – 25.0 (kg/m2), 6.1% among women with a BMI from 25 – 30 (kg/m2) and 7.2% among women with a BMI > 30 (kg/m2) (P = 0.07). Multivariate logistic regression analysis adjusting for age, race/ethnicity, income, and insurance status revealed a non-significant odds ratio of 1.44 (95% CI 0.85, 2.42, P = 0.17) among women in the highest BMI category compared with women in the healthy BMI category. Variables independently associated with rarely or never having had a Pap test included older age (>45 years) and lack of insurance. Associations between obesity and infrequent cervical cancer screening appear to be largely explained by sociodemographic variables, however this question should be further explored using data from a larger national survey.

Learning Objectives:
Describe the association between obesity and cervical cancer screening for a population of women in California.

Keywords: Cervical Cancer, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a second year medical student at the UC Berkeley - UCSF Joint Medical Program. In addition to getting a doctorate in medicine degree, I am conducting an original research project to earn a master's degree in health and medical sciences. I have taken extensive coursework in medical science as well as epidemiology and statistics. The focus of my master's thesis is on the impact of the HPV vaccine on cervical cancer disease. My research on this topic has lead to complementary interests in cervical cancer screening patterns and barriers to preventive services.
Any relevant financial relationships? No

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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