Effect of Obesity on Cervical Cancer Screening and Outcomes

Gnade, Colette; Hill, Emily K.; Botkin, Hannah E.; Hefel, Alison R.; Hansen, Hayley; Sheets, Kelsey; Mott, Sarah L.; Hardy-Fairbanks, Abbey J; Stockdale, Colleen K.

doi:10.1097/lgt.0000000000000570

Cited by 19 publications

(15 citation statements)

References 20 publications

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“…Findings suggest that women living with obesity and severe and complex obesity have disproportionate inappropriate screening before cervical cancer diagnosis, and women living with severe and complex obesity have worse overall survival rates than normal weight counterparts. 37 This raises important potential areas for future research in relation to the availability of cancer screening, which is context‐specific and situationally determined for many women.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of obesity as a barrier to accessing cancer screening services

Graham

Hayes²,

Cox

et al. 2022

Obesity Science & Practice

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Introduction:Obesity is a known risk factor for the development of cancers, and a significant proportion of the population may be at risk of developing cancer owing to their weight status. There is acknowledged societal stigma towards people living with obesity, which can influence health behaviors and deter help seeking, such as cancer screening. Healthcare professionals' attitudes and views toward people living with obesity may adversely affect the patient-professional interface and treatment.Methods: A systematic review was carried out which aimed to explore the impact of living with obesity on the uptake of three main cancer-screening services: breast, cervical, and colorectal.Results: Ten studies were included in the review. Three main areas were identified from both a patient and healthcare professional perspective: barriers and challenges to screening, gender issues, and disparities in the population living with obesity. Conclusion:Further research is needed to improve uptake of cancer screening services, and for education on weight bias, which is often unconscious, to be considered for healthcare professionals working in cancer screening services. This may help to increase the incidence of early differential diagnosis of potential cancers and improve health outcomes for people living with obesity. K E Y W O R D Sbarriers, cancer screening, obesity | INTRODUCTIONObesity (BMI kg/m 2 ) is a known risk factor for the development of cancers 1,2 with evidence suggesting an increase in cancers such as breast in postmenopausal women, colorectal (higher risk in males), endometrial, esophageal adenocarcinoma, gall bladder, and renal. 1,3 Gender differences in cancer risk among people living with obesity, including the incidence of esophageal, liver, and colorectal cancer, due in part to disparities in body fat distribution between men and women, 4 The rates of obesity have tripled globally since 1975, and as of 2016, the World Health Organization estimated there were 650 million people living with obesity. 5 By 2030, the rates are predicted to increase to one in five women and one in seven men, meaning over 1 billion people across the globe will be living with obesity. 6 Notably,This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

A systematic review of obesity as a barrier to accessing cancer screening services

Graham

Hayes²,

Cox

et al. 2022

Obesity Science & Practice

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“…Some researchers have also reported that obesity is weakly associated with an increased risk of cervical cancer [ 31 ]. One interesting study showed that obese women are at increased risk of having inappropriate cervical cancer screenings before cancer diagnosis, possibly due to a negative body image, bias on the part of health care providers, poor health behaviors, and comorbidities affecting regular care [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Secondhand smoke exposure, diabetes, and high BMI are risk factors for uterine cervical cancer: a cross-sectional study from the Korea national health and nutrition examination survey (2010–2018)

et al. 2021

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Background Human papilloma virus infection and tobacco smoking are the major risk factors for cervical cancer. There are limited studies searching other risk factors for cervical cancer and the results are not consistent. This study investigated the relations between cervical cancer and possible risk factors, including secondhand cigarette smoke exposure, diabetes, body mass index (BMI), and work schedule. Methods In this cross-sectional study, 29,557 women completed a cervical cancer questionnaire and were selected using 2010–2018 data from the Korea National Health and Nutrition Examination Survey. Details in secondhand smoke exposure, diabetes, BMI, and work schedule were assessed with participants’ health interviews and health-related surveys. Results Two hundred sixty-two women (0.89%) in the sample were diagnosed with cervical cancer. Domestic secondhand smoke exposure, diabetes, and high BMI significantly increased cervical cancer risk. Respective odds ratios and 95% confidence intervals were: 1.547 (1.042–2.297), 2.156 (1.535–3.027), and 1.036 (1.006–1.067). Weekly work hours, and work schedule were not significantly related to cervical cancer incidence. Conclusion Among Korean women, passive exposure to cigarette smoke at home, diabetes, and high BMI increase risk for cervical cancer.

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“…Patients have also reported embarrassment when weighed and a lack of appropriately sized medical equipment 22,6 . Negative health care experiences and weight bias have also disproportionately influenced the frequency of recommended gynecologic and mammogram screenings 48–50 . Additionally, patients in larger bodies have higher rates of unplanned pregnancies compared with those in smaller bodies 51 .…”

Section: Factors Associated With Weight Biasmentioning

confidence: 99%

Mitigating Weight Bias in the Clinical Setting: A New Approach to Care

Olson,

Muñoz,

Solis

et al. 2023

J Midwife Womens Health

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Weight bias toward patients in larger bodies is pervasive among health care providers and can negatively influence provider‐patient communication, as well as patients’ behavior and health outcomes. Weight bias has historical roots that perpetuate thinness and Whiteness as the cultural norm. Although weight bias remains socially acceptable in US culture, contributing factors to an individual's body size are complex and multifactorial. Providers and health care systems also consistently use body mass index (BMI) as an indicator of health status, despite its limitations and harmful effects in the clinical setting. This state of the science review presents 8 evidence‐based strategies that demonstrate how to mitigate harm from weight bias and improve quality of care and health outcomes for patients living in larger bodies. Person‐centered approaches to care include (1) eliminating clinical recommendations to lose weight; (2) shifting from a focus on weight to health; (3) implementing a size and weight‐inclusive approach; (4) engaging in weight bias self‐evaluation; (5) creating a welcoming environment for patients of all sizes; (6) seeking permission and learning the patient's story; (7) using weight‐inclusive language; and (8) re‐evaluating clinical guidelines and policies based on BMI. Midwives and other health care providers may benefit from training that re‐imagines the delivery of health care to patients in larger bodies.

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Effect of Obesity on Cervical Cancer Screening and Outcomes

Cited by 19 publications

References 20 publications

A systematic review of obesity as a barrier to accessing cancer screening services

A systematic review of obesity as a barrier to accessing cancer screening services

Secondhand smoke exposure, diabetes, and high BMI are risk factors for uterine cervical cancer: a cross-sectional study from the Korea national health and nutrition examination survey (2010–2018)

Mitigating Weight Bias in the Clinical Setting: A New Approach to Care

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