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Title:
Obesity and Mammography: A Systematic Review and Meta-Analysis | Journal of General Internal Medicine
Description:
BACKGROUND Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. OBJECTIVES To quantify the relationship between body weight and mammography in white and black women. DATA SOURCES AND REVIEW METHODS We identified original articles evaluating the relationship between weight and mammography in the United States through electronic and manual searching using terms for breast cancer screening, breast cancer, and body weight. We excluded studies in special populations (e.g., HIV-positive patients) or not written in English. Citations and abstracts were reviewed independently. We abstracted data sequentially and quality information independently. RESULTS Of 5,047 citations, we included 17 studies in our systematic review. Sixteen studies used self-reported body mass index (BMI) and excluded women <40 years of age. Using random-effects models for the six nationally representative studies using standard BMI categories, the combined odds ratios (95% CI) for mammography in the past 2 years were 1.01 (0.95 to 1.08), 0.93 (0.83 to 1.05), 0.90 (0.78 to 1.04), and 0.79 (0.68 to 0.92) for overweight (25–29.9 kg/m2), class I (30–34.9 kg/m2), class II (35–39.9 kg/m2), and class III (≥40 kg/m2) obese women, respectively, compared to normal-weight women. Results were consistent when all available studies were included. The inverse association was found in white, but not black, women in the three studies with results stratified by race. CONCLUSIONS Morbidly obese women are significantly less likely to report recent mammography. This relationship appears stronger in white women. Lower screening rates may partly explain the higher breast cancer mortality in morbidly obese women.
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Keywords {🔍}
cancer, mammography, obesity, google, scholar, article, women, breast, pubmed, studies, screening, study, bmi, data, included, health, results, cas, body, class, reported, weight, review, obese, kgm, articles, categories, med, overweight, recent, white, black, adequate, analyses, report, risk, mortality, relationship, race, search, nationally, representative, inadequate, full, iii, based, fair, care, years, association,
Topics {✒️}
gov/nccdphp/dnpa/obesity/trend/index org/pdf%20hochladen/strobe-checklist-version3 article download pdf gov/clinic/uspstf/uspsbrca mid-career investigator award intra-rater reliability post-doctoral epidemiology trainee full article review reported cancer-screening histories breast cancer surgery reported race-stratified results36 implicit anti-fat bias cancer-related health behaviors obesity-related body image65–67 race-stratified meta-analysis postmenopausal breast cancer obesity-related chronic diseases privacy choices/manage cookies african-american obese women jersey medical school adams-campbell ll project-specific support conducted unstratified meta-analyses recent meta-analysis found table 3 quality review full axillary resection relevant clinical experience quantitative variables explained mortality web-based report johns hopkins university appendix table 5 appendix table 5 body mass index body-mass index quantitative results requested28 obese postmenopausal women article exploring weight systematic review experience breast cancer risk delay medical care55 nationally representative surveys27 lymph node-negative sample size rationalization cancer screening clinic breast cancer screening breast-cancer screening breast cancer recurrence20 nationally representative surveys important risk factor jones ba
Questions {❓}
- , standard error, standard deviation, confidence intervals) reported?
- Can mammography screening explain the race difference in stage at diagnosis of breast cancer?
- Can obesity explain the racial difference in stage of breast cancer at diagnosis between black and white women?
- Does utilization of screening mammography explain racial and ethnic differences in breast cancer?
- For main analyses, were numbers of individuals experiencing the outcome reported?
- For what percentage of participants were there missing data?
- How did the study report the numbers of individuals at each stage of the study?
- How was the study population selected?
- If data abstracted from medical records, was inter- and intra-rater reliability described?
- If the study involved medical record review, was there a description of handling of disagreements?
- If the study involved medical record review, was there blinding of abstractors to the study question?
- If the study involved medical record review, was there standardized data abstraction?
- If the study used a survey, was the survey response rate reported?
- Implicit anti-fat bias among health professionals: is anyone immune?
- Is there time for management of patients with chronic diseases in primary care?
- Nonadherence to breast and cervical cancer screening: what are the linkages to chronic disease risk?
- Primary care: is there enough time for prevention?
- Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care?
- The relationship of obesity to the frequency of pelvic examination: do physician and patient attitudes make a difference?
- Was the exposure well-described?
- Was the outcome well-described?
- Was the study population described?
- Was the study setting described?
- Was there a discussion of sample size rationalization?
- Was there information on excluded or non-participating subjects?
- Were confounding factors treated adequately?
- Were key baseline characteristics ascertained?
- Were methods for use of quantitative variables explained?
- Were objectives and pre-specified hypotheses reported?
- Were sources of funding identified?
- Were statistical analyses clearly described?
- What's the relative risk?
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headline:Obesity and Mammography: A Systematic Review and Meta-Analysis
description:Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. To quantify the relationship between body weight and mammography in white and black women. We identified original articles evaluating the relationship between weight and mammography in the United States through electronic and manual searching using terms for breast cancer screening, breast cancer, and body weight. We excluded studies in special populations (e.g., HIV-positive patients) or not written in English. Citations and abstracts were reviewed independently. We abstracted data sequentially and quality information independently. Of 5,047 citations, we included 17 studies in our systematic review. Sixteen studies used self-reported body mass index (BMI) and excluded women <40 years of age. Using random-effects models for the six nationally representative studies using standard BMI categories, the combined odds ratios (95% CI) for mammography in the past 2 years were 1.01 (0.95 to 1.08), 0.93 (0.83 to 1.05), 0.90 (0.78 to 1.04), and 0.79 (0.68 to 0.92) for overweight (25–29.9 kg/m2), class I (30–34.9 kg/m2), class II (35–39.9 kg/m2), and class III (≥40 kg/m2) obese women, respectively, compared to normal-weight women. Results were consistent when all available studies were included. The inverse association was found in white, but not black, women in the three studies with results stratified by race. Morbidly obese women are significantly less likely to report recent mammography. This relationship appears stronger in white women. Lower screening rates may partly explain the higher breast cancer mortality in morbidly obese women.
datePublished:2009-03-11T00:00:00Z
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headline:Obesity and Mammography: A Systematic Review and Meta-Analysis
description:Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. To quantify the relationship between body weight and mammography in white and black women. We identified original articles evaluating the relationship between weight and mammography in the United States through electronic and manual searching using terms for breast cancer screening, breast cancer, and body weight. We excluded studies in special populations (e.g., HIV-positive patients) or not written in English. Citations and abstracts were reviewed independently. We abstracted data sequentially and quality information independently. Of 5,047 citations, we included 17 studies in our systematic review. Sixteen studies used self-reported body mass index (BMI) and excluded women <40 years of age. Using random-effects models for the six nationally representative studies using standard BMI categories, the combined odds ratios (95% CI) for mammography in the past 2 years were 1.01 (0.95 to 1.08), 0.93 (0.83 to 1.05), 0.90 (0.78 to 1.04), and 0.79 (0.68 to 0.92) for overweight (25–29.9 kg/m2), class I (30–34.9 kg/m2), class II (35–39.9 kg/m2), and class III (≥40 kg/m2) obese women, respectively, compared to normal-weight women. Results were consistent when all available studies were included. The inverse association was found in white, but not black, women in the three studies with results stratified by race. Morbidly obese women are significantly less likely to report recent mammography. This relationship appears stronger in white women. Lower screening rates may partly explain the higher breast cancer mortality in morbidly obese women.
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