OBESITY AND BREAST CANCER SCREENING: CROSS-SECTIONAL SURVEY

Najlaa Saadi Sheet Al-Safar*

ABSTRACT

Background: Breast cancer is a leading cause of cancer-related mortality among women, with early detection through mammography screening significantly reducing death rates. Despite these benefits, adherence to screening guidelines varies due to multiple barriers, including socioeconomic status, racial disparities, and geographic access. Obesity, a known risk factor for breast cancer, may influence mammography utilization, but the relationship remains inconsistent across studies. This study aimed to examine the association between body mass index (BMI) and mammography use, particularly across racial and ethnic groups, to address potential disparities in screening uptake. Methods: A retrospective cross-sectional analysis was conducted using data health survey. Women aged 50–74 years without a prior breast cancer diagnosis were included (N=10,000). Self-reported mammography use within the past two years served as the primary outcome, while BMI was the main exposure variable, categorized as normal (18.5–24.9 kg/m²), overweight (25–29.9 kg/m²), obese class I (30–34.9 kg/m²), obese class II (35–39.9 kg/m²), and obese class III (≥40 kg/m²). Additional variables included demographics, socioeconomic status, and healthcare access. Statistical analyses included descriptive statistics, chi-squared tests, logistic regression, and cubic spline regression to assess the relationship between BMI and mammography use. Results: Among respondents, 75.5% reported undergoing mammography within the past two years. Mammography use decreased with increasing BMI, with the lowest rates observed in obese class III women. Higher BMI was associated with younger age, lower educational attainment, lower income, and being unmarried (p<0.01). Multivariable logistic regression revealed that women in obese class II (OR 0.85, 95% CI: 0.78–0.93) and obese class III (OR 0.78, 95% CI: 0.70–0.87) had significantly lower odds of undergoing mammography compared to women with normal BMI. Racial and ethnic disparities further compounded these trends, particularly among underserved populations. Conclusion: Obesity negatively impacts mammography uptake, with obese class III women being the least likely to adhere to screening guidelines. These findings highlight the need for targeted interventions to address barriers to screening in obese women, with particular focus on racial and socioeconomic disparities. Improving access to mammography and addressing weight-related stigma in healthcare settings may enhance screening rates, ultimately reducing breast cancer mortality.

Keywords: Additional variables included demographics, socioeconomic status, and healthcare access.