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BMC Cancer
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Body mass index and participation in organized mammographic screening: a prospective cohort study

Authors: Sophie Sell Hellmann, Sisse Helle Njor, Elsebeth Lynge, My von Euler-Chelpin, Anja Olsen, Anne Tjønneland, Ilse Vejborg, Zorana Jovanovic Andersen

Published in: BMC Cancer | Issue 1/2015

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Abstract

Background

Breast cancer is the leading cancer among women, and early diagnosis is essential for future prognosis. Evidence from mainly cross-sectional US studies with self-reported exposure and outcome found positive association of body mass index (BMI) with non-participation in mammographic screening, but hardly addressed the influence of potential effect-modifiers. We studied the association between objective measures of BMI and participation in mammographic screening in a Danish prospective cohort, and explored the influence of menopausal status, hormone therapy (HT), previous screening participation, and morbidities on this relationship.

Methods

A total of 5,134 women from the Diet, Cancer, and Health cohort who were invited to population based mammographic screening in Copenhagen were included in analysis. Women were 50–64 years old at inclusion (1993–97) when their height and weight were measured and covariates collected via questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) for the association between BMI and mammographic screening participation were estimated by logistic regression, adjusted for other breast cancer risk factors and morbidities. Effect modification was evaluated by an interaction term and tested by Wald test.

Results

Underweight (BMI < 18.5 kg/m2, OR: 95% CI; 2.24: 1.27-3.96) and obese women of class II (BMI 35–40 kg/m2, 1.54: 0.99-2.39) and III (BMI ≥ 40 kg/m2, 1.81: 0.95-3.44) had significantly higher odds of non-participation than women with normal weight. This association was limited to postmenopausal women (Wald test p = 0.08), with enhanced non-participation in underweight (2.83: 1.52-5.27) and obese women of class II and III (1.84: 1.15-2.95; 2.47: 1.20-5.06) as compared to normal weight postmenopausal women. There was no effect modification by HT, previous screening participation, or morbidities, besides suggestive evidence of enhanced non-participation in diabetic overweight and obese women.

Conclusions

Underweight and very obese postmenopausal women were significantly less likely to participate in mammographic screening than women with normal weight, while BMI was not related to screening in premenopausal women. Effect of BMI on mammographic screening participation was not significantly modified by HT, previous screening participation, or morbidities.
Literature
1.
Curado MP. Breast cancer in the world: incidence and mortality. Salud Publica Mex. 2011;53:372–84.PubMed
2.
Soerjomataram I, Louwman MW, Ribot JG, Roukema JA, Coebergh JW. An overview of prognostic factors for long-term survivors of breast cancer. Breast Cancer Res Treat. 2008;107:309–30.CrossRefPubMed
3.
Perry N, Broeders M, de Wolf C, Tornberg S, Holland R, von Karsa L. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition–summary document. Ann Oncol. 2008;19:614–22.CrossRefPubMed
4.
Boyd NF, Martin LJ, Sun L, Guo H, Chiarelli A, Hislop G, et al. Body size, mammographic density, and breast cancer risk. Cancer Epidemiol Biomarkers Prev. 2006;15:2086–92.CrossRefPubMed
5.
Harris HR, Tamimi RM, Willett WC, Hankinson SE, Michels KB. Body size across the life course, mammographic density, and risk of breast cancer. Am J Epidemiol. 2011;174:909–18.CrossRefPubMedPubMedCentral
6.
Ligibel J. Obesity and breast cancer. Oncology (Williston Park). 2011;25:994–1000.
7.
Cohen SS, Palmieri RT, Nyante SJ, Koralek DO, Kim S, Bradshaw P, et al. Obesity and screening for breast, cervical, and colorectal cancer in women: a review. Cancer. 2008;112:1892–904.CrossRefPubMed
8.
Fagan HB, Wender R, Myers RE, Petrelli N. Obesity and cancer screening according to race and gender. J Obes. 2011;2011:218250.PubMedPubMedCentral
9.
10.
11.
Rothman KJ. BMI-related errors in the measurement of obesity. Int J Obes (Lond). 2008;32 Suppl 3:S56–9.CrossRef
12.
Tjonneland A, Olsen A, Boll K, Stripp C, Christensen J, Engholm G, et al. Study design, exposure variables, and socioeconomic determinants of participation in diet, cancer and health: a population-based prospective cohort study of 57,053 men and women in Denmark. Scand J Publ Health. 2007;35:432–41.CrossRef
13.
Jensen A, Olsen AH, von Euler-Chelpin M, Helle NS, Vejborg I, Lynge E. Do nonattenders in mammography screening programmes seek mammography elsewhere? Int J Cancer. 2005;113:464–70.CrossRefPubMed
14.
Pedersen CB. The Danish civil registration system. Scand J Publ Health. 2011;39:22–5.CrossRef
15.
Domingo L, Jacobsen KK, von Euler-Chelpin M, Vejborg I, Schwartz W, Sala M, et al. Seventeen-years overview of breast cancer inside and outside screening in Denmark. Acta Oncol. 2013;52:48–56.CrossRefPubMed
16.
Vejborg I, Olsen AH, Jensen MB, Rank F, Tange UB, Lynge E. Early outcome of mammography screening in Copenhagen 1991–99. J Med Screen. 2002;9:115–9.CrossRefPubMed
17.
Banerjea R, Findley PA, Sambamoorthi U. Disparities in preventive care by body mass index categories among women. Women Health. 2008;47:1–17.CrossRefPubMed
18.
19.
Cohen SS, Signorello LB, Gammon MD, Blot WJ. Obesity and recent mammography use among black and white women in the southern community cohort study (United States). Cancer Causes Control. 2007;18:765–73.CrossRefPubMed
20.
Coughlin SS, Uhler RJ, Hall HI, Briss PA. Nonadherence to breast and cervical cancer screening: what are the linkages to chronic disease risk? Prev Chronic Dis. 2004;1:A04.PubMed
21.
Ferrante JM, Chen PH, Jacobs A. Breast and cervical cancer screening in obese minority women. J Womens Health (Larchmt ). 2006;15:531–41.CrossRef
22.
Ferrante JM, Chen PH, Crabtree BF, Wartenberg D. Cancer screening in women: body mass index and adherence to physician recommendations. Am J Prev Med. 2007;32:525–31.CrossRefPubMedPubMedCentral
23.
Fontaine KR, Faith MS, Allison DB, Cheskin LJ. Body weight and health care among women in the general population. Arch Fam Med. 1998;7:381–4.CrossRefPubMed
24.
Fontaine KR, Heo M, Allison DB. Body weight and cancer screening among women. J Womens Health Gend Based Med. 2001;10:463–70.CrossRefPubMed
25.
Hunt KA, Sickles EA. Effect of obesity on screening mammography: outcomes analysis of 88,346 consecutive examinations. AJR Am J Roentgenol. 2000;174:1251–5.CrossRefPubMed
26.
Mitchell RS, Padwal RS, Chuck AW, Klarenbach SW. Cancer screening among the overweight and obese in Canada. Am J Prev Med. 2008;35:127–32.CrossRefPubMed
27.
Ostbye T, Taylor Jr DH, Yancy Jr WS, Krause KM. Associations between obesity and receipt of screening mammography, papanicolaou tests, and influenza vaccination: results from the health and retirement study (HRS) and the asset and health dynamics among the oldest Old (AHEAD) study. Am J Public Health. 2005;95:1623–30.CrossRefPubMedPubMedCentral
28.
Wee CC, McCarthy EP, Davis RB, Phillips RS. Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care? Ann Intern Med. 2000;132:697–704.CrossRefPubMed
29.
30.
Zhu K, Wu H, Jatoi I, Potter J, Shriver C. Body mass index and use of mammography screening in the United States. Prev Med. 2006;42:381–5.CrossRefPubMed
31.
Lawlor DA, Bedford C, Taylor M, Ebrahim S. Agreement between measured and self-reported weight in older women. Results from the British women’s heart and health study. Age Ageing. 2002;31:169–74.CrossRefPubMed
32.
Stommel M, Schoenborn CA. Accuracy and usefulness of BMI measures based on self-reported weight and height: findings from the NHANES & NHIS 2001–2006. BMC Public Health. 2009;9:421.CrossRefPubMedPubMedCentral
33.
Cheraghi Z, Poorolajal J, Hashem T, Esmailnasab N, Doosti IA. Effect of body mass index on breast cancer during premenopausal and postmenopausal periods: a meta-analysis. PLoS One. 2012;7:e51446.CrossRefPubMedPubMedCentral
34.
De Bruijn KM, Arends LR, Hansen BE, Leeflang S, Ruiter R, van Eijck CH. Systematic review and meta-analysis of the association between diabetes mellitus and incidence and mortality in breast and colorectal cancer. Br J Surg. 2013;100:1421–9.CrossRefPubMed
35.
Kjellen M, von Euler-Chelpin M. Socioeconomic status as determinant for participation in mammography screening: assessing the difference between using women’s own versus their partner’s. Int J Publ Health. 2010;55:209–15.CrossRef
36.
von Euler-Chelpin M, Olsen AH, Njor S, Vejborg I, Schwartz W, Lynge E. Women’s patterns of participation in mammography screening in Denmark. Eur J Epidemiol. 2006;21:203–9.CrossRef
37.
von Euler-Chelpin M, Olsen AH, Njor S, Jensen A, Vejborg I, Schwartz W, et al. Does educational level determine screening participation? Eur J Cancer Prev. 2008;17:273–8.CrossRef
38.
von Euler-Chelpin M, Olsen AH, Njor S, Vejborg I, Schwartz W, Lynge E. Socio-demographic determinants of participation in mammography screening. Int J Cancer. 2008;122:418–23.CrossRef
39.
Barr JK, Franks AL, Lee NC, Herther P, Schachter M. Factors associated with continued participation in mammography screening. Prev Med. 2001;33:661–7.CrossRefPubMed
40.
Friedman AM, Hemler JR, Rossetti E, Clemow LP, Ferrante JM. Obese women’s barriers to mammography and pap smear: the possible role of personality. Obesity (Silver Spring). 2012;20:1611–7.CrossRef
41.
Wang YY, Lehuede C, Laurent V, Dirat B, Dauvillier S, Bochet L, et al. Adipose tissue and breast epithelial cells: a dangerous dynamic duo in breast cancer. Cancer Lett. 2012;324:142–51.CrossRefPubMed
42.
Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review. Lancet. 2012;380:1778–86.CrossRef
43.
McCormack VA, Dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2006;15:1159–69.CrossRefPubMed
Metadata
Title
Body mass index and participation in organized mammographic screening: a prospective cohort study
Authors
Sophie Sell Hellmann
Sisse Helle Njor
Elsebeth Lynge
My von Euler-Chelpin
Anja Olsen
Anne Tjønneland
Ilse Vejborg
Zorana Jovanovic Andersen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1296-8

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