“Weighing in” on screening mammography

Abstract

6523 Background. Obesity is associated with an increased risk of breast cancer in postmenopausal women. In previous studies, obesity has been associated with decreased utilization of screening mammography (SM). We examined the association between Body Mass Index (BMI) and compliance with recommended SM using data from the 2004 Behavioral Risk Factor Surveillance Survey (BRFSS). Patients and Methods. The BRFSS included 130,185 female participants, aged 40 and older, who were randomly selected to participate in the world's largest telephone survey. After weighted analysis, this is believed to be representative of 56,226,220 non-institutionalized US women in this age group. The primary endpoint was the proportion of women who underwent SM within the two years preceding the survey. Utilization of SM in normal weight women (BMI 18.5–24.99) was compared with underweight (<18.5), overweight (25–29.99) and women with obesity class I (30–34.99), class II (35–39.99) and class III (≥40) using logistic regression analysis. Results. The sample included 1.91% underweight, 37.91% normal weight, 30.15% overweight and 14.36%, 5.44% and 3.49% women in obesity classes I, II, and III, respectively. Adjusting for age, race, smoking status, general health perception, level of education, and income level, underweight women were less likely to comply with regular SM than normal weight women (OR 0.57; 95% CI, 0.48–0.68). In contrast, overweight women had a significantly higher rate of appropriate SM utilization (OR 1.08; 95% CI 1.01–1.15). Women with class I and class II obesity showed a statistically non- significant trend towards a higher utilization of SM (OR 1.08; 95% CI 0.99–1.18) and (OR 1.10; 95% CI 0.98–1.25), respectively, while women with class III obesity showed a non-significant trend (OR 0.97; 95% CI, 0.84–1.13) towards under-utilization of SM. Conclusion. We present a weighted analysis of the BRFSS, evaluating the association of BMI and compliance with recommended SM among women 40 years and older. These results may be generalized to the US population of women in this age range. Previous studies reporting under-utilization of SM in higher risk, overweight and obese women were not confirmed in this large population-based analysis. No significant financial relationships to disclose.