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Disparities in Care: Obesity and Cancer Screening

$0R03FY2002HSAHRQ

Beth Israel Deaconess Medical Center, Boston MA

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Abstract

DESCRIPTION: Obesity is the second leading cause of preventable deaths. Cancers of the colon, prostate, breast, and cervix account for many of these deaths. Despite their higher risk, preliminary analyses suggests that women with obesity may be screened less often than women without obesity for breast and cervical cancer. Whether disparities in cancer screening extend to men with obesity is unknown. Because of cultural and gender differences in self- perception, race and sex may also influence the relationship between obesity and disparities in screening. This project will use national data collected as part of the 1998 National Health Interview Survey (NHIS) and the 1996 Medical Expenditure Panel Survey (MEPS) to 1) compare the rates of screening for colon, prostate, breast, and cervical cancer between persons with and without obesity based on national screening guidelines, 2) examine whether differences in cancer screening rates associated with obesity vary by sex and race, and 3) examine whether differences in screening rates can be explained entirely by the higher illness burden experienced by persons with obesity. Using statistical modeling, the investigators will quantify differences in screening rates between persons with and without obesity after accounting for sociodemographic factors (such as age, race, education, income, region of the country), access to care, and medical conditions. The investigators will also examine the association between weight and cancer screening in different racial subgroups. For colon cancer screening, the relationship between obesity and screening will be examined among men and women separately. Findings from this project will help determine whether obesity is a barrier to cancer screening and help researchers and clinicians begin to understand factors that contribute to disparities in screening. Recognizing and understanding the role of obesity as a potential barrier to care is the first step towards improving quality of care for patients with obesity.

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