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Review
. 2009 Feb;17(2):375-81.
doi: 10.1038/oby.2008.480. Epub 2008 Nov 6.

The association of obesity and cervical cancer screening: a systematic review and meta-analysis

Nisa M Maruthur  1 , Shari D Bolen, Frederick L Brancati, Jeanne M Clark
Affiliations
Review

The association of obesity and cervical cancer screening: a systematic review and meta-analysis

Nisa M Maruthur et al. Obesity (Silver Spring). 2009 Feb.

Abstract

Obese women are at an increased risk of death from cervical cancer, but the explanation for this is unknown. Through our systematic review, we sought to determine whether obesity is associated with cervical cancer screening and whether this association differs by race. We identified original articles evaluating the relationship between body weight and Papanicolaou (Pap) testing in the United States through electronic (PubMed, CINAHL, and the Cochrane Library) and manual searching. We excluded studies in special populations or those not written in English. Two reviewers sequentially extracted study data and independently extracted quality using standardized forms. A total of 4,132 citations yielded 11 relevant studies. Ten studies suggested an inverse association between obesity and cervical cancer screening. Compared to women with a normal BMI, the combined odds ratios (95% CI) for Pap testing were 0.91 (0.80-1.03), 0.81 (0.70-0.93), 0.75 (0.64-0.88), and 0.62 (0.55-0.69) for the overweight and class I, class II, and class III obesity categories, respectively. Three out of four studies that presented the results by race found this held true for white women, but no study found this for black women. In conclusion, obese women are less likely to report being screened for cervical cancer than their lean counterparts, and this does not hold true for black women. Less screening may partly explain the higher cervical cancer mortality seen in obese white women.

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Figures

Figure 1
Figure 1
Search Strategy aReasons for exclusion add up to more than the number abstracts excluded because reviewers could have more than one reason for exclusion.
Figure 2
Figure 2
Combined Odds Ratios for Papanicolaou Testing by BMI Category BMI, body mass index; OR, odds ratio; CI, confidence interval. NOTE: BMI Category: normal weight, BMI 18–24.9 kg/m2; overweight, BMI 25–29.9 kg/m2; class I obesity, BMI 30–34.9 kg/m2; class II obesity, BMI 35–39.9 kg/m2; class III obesity, BMI ≥ 40kg/m2.
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References

    1. Screening for squamous cervical cancer: Duration of low risk after negative results of cervical cytology and its implication for screening policies. IARC working group on evaluation of cervical cancer screening programmes. Br Med J (Clin Res Ed) 1986 Sep 13;293(6548):659–64. - PMC - PubMed
    1. Sasieni PD, Cuzick J, Lynch-Farmery E. Estimating the efficacy of screening by auditing smear histories of women with and without cervical cancer. The National Coordinating Network for Cervical Screening Working Group. Br J Cancer. 1996 Apr;73(8):1001–5. - PMC - PubMed
    1. Screening for cervical cancer: Recommendations and rationale. Jan, 2003. homepage on the Internet. Available from: http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm. - PubMed
    1. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003 Apr 24;348(17):1625–38. - PubMed
    1. Amonkar MM, Madhavan S. Compliance rates and predictors of cancer screening recommendations among Appalachian women. J Health Care Poor Underserved. 2002 Nov;13(4):443–60. - PubMed