What Roles Do Gender, Race, and Obesity Play in Cancer Screening?

Lead author Heather Fagan adds, “A greater understanding of the relationship between cancer screening and obesity, race/ethnicity and gender can help explain the association between obesity and increased cancer mortality."
Following tobacco, obesity is the second highest risk factor for developing cancer. Obesity is also associated with a higher death rate for all cancers combined and also for specific cancers, such as cancer of the prostate, colon/rectum, and cervix.

Research has already established that a higher body weight was consistently linked to lower rates of Pap smear use in cervical cancer screening. According to studies, this was most apparent in white women, whilst black women, mainly in those with a high socioeconomic status displayed an absent or weaker association.

Unlike cervical cancer screening, increased prostate cancer screening levels were found to be consistent with greater weight. In the case of three out of four studies, obese men had a higher chance of receiving a PSA prostate cancer screening test compared with men of normal weight. The researchers state that the finding appears to be consistent among all races and ethnicities.

Study author Richard Wender adds, "This could be explained by differences in access and utilization of health care; as weight increases so do other comorbid conditions, making heavier men higher users of health care and perhaps more encouraged to be tested by their health care provider."

Additional study findings revealed that women with greater weight levels also received less screening for colorectal cancer. Though there was no reference to racial disparities, there were inconsistencies in the link between obesity and colorectal screening in men. Overall the findings reveal that endoscopy and not fecal occult blood tests were more likely to be influenced by a person’s weight status, particularly amongst women. The researchers believe this could be related with endoscopy being a more invasive screening procedure and could have more complications in obese patients compared with other screening tests.

The authors conclude, “Screening behaviors can vary by ethnicity/race and gender, but more research is needed to create a comprehensive understanding of obesity and cancer screening in race-gender subgroups such as white men, white women, black men and black women, accounting for the effects of the doctor-patient relationship, access to care and type of screening test."