Cancer screening among the overweight and obese in Canada
Cancer screening among the overweight and obese in Canada
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DOI：
10.1016/j.amepre.2008.03.031
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发表时间：
2008-08-01
影响因子：
5.5
通讯作者：
Klarenbach, Scott W.
中科院分区：
文献类型：
--
作者：
Mitchell, Rebecca S.;Padwal, Rai S.;Klarenbach, Scott W.
背景资料：尽管超重和肥胖男性和女性的癌症发病率和死亡率增加，但美国研究报告了这些受试者中癌症筛查的使用减少。我们试图分析超重/肥胖和癌症筛查的做法，使用人口为基础的加拿大data.Methods：在加拿大社区健康调查2003年提供完整的信息，关于感兴趣的变量进行了分析，从成年人的反应。癌症筛查方式包括巴氏涂片检查、乳房X光检查和粪便潜血检查，并以加拿大预防健康工作组的当代建议为基础。在调整了人口统计学和社会经济因素、健康习惯、医疗服务可及性和肥胖相关的合并症后，使用logistic回归分析探讨超重/肥胖与癌症筛查之间的关联。结果：与正常体重对照组相比，超重和肥胖妇女接受宫颈癌筛查的可能性明显降低。在完全校正的模型中，肥胖的增加与巴氏涂片检查的几率降低相关，超重、I类、II类和III类肥胖的95%OR分别为0.87（0.81，0.94）、0.79（0.72，0.88）、0.62（0.54，0.71）和0.61（0.53，0.72）。两年一次的乳腺癌和结直肠癌筛查的患病率在很大程度上不受体重的调整analysis.Conclusions：超重和肥胖与宫颈癌筛查的利用率显着降低，尽管疾病的风险增加。这种关联独立于社会人口学因素、合并症和医疗服务。这与美国人群的研究结果一致，并表明患者和提供者因素比医疗保健系统因素对筛查的障碍更大。
Background: Despite increased cancer incidence and mortality among overweight and obese men and women, U.S. studies have reported the reduced use of cancer screening among these Subjects. We sought to analyze the relationship between overweight/obesity and cancer screening practices using population-based Canadian data.Methods: Responses from adults surveyed in the Canadian Community Health Survey 2003 who provided complete information regarding variables of interest were analyzed. Cancer screening modalities included Pap smear testing, mammography, and fecal occult blood testing, and were based on contemporary recommendations of the Canadian Task Force for Preventive Health. The association between overweight/obesity and cancer screening was explored using logistic regression after adjusting for demographic and socioeconomic factors, health habits, healthcare access, and obesity-related comorbidity. The analysis was conducted in 2007.Results: Compared to normal-weight controls, overweight and obese women were significantly less likely to have undergone cervical cancer screening. In the fully adjusted model, increasing obesity was associated with decreasing odds of Pap smear testing, with overweight, Class-I, -II, and -III obesity having 95% ORs of 0.87 (0.81, 0.94); 0.79 (0.72, 0.88); 0.62 (0.54, 0.71); and 0.61 (0.53, 0.72), respectively. The prevalence of biennial breast and colorectal cancer screenings was largely unaffected by weight in the adjusted analyses.Conclusions: Overweight and obesity are associated with markedly lower utilization of cervical cancer screening, despite increased disease risks. This association is independent of sociodemographic factors, comorbidity, and healthcare access. This is consistent with findings in U.S. populations, and suggests that patient and provider factors serve as greater barriers to screening than do healthcare system factors.