Study Finds That Obesity Stigma May Stop Women From Getting Mammograms

Regular breast cancer screenings can be a lifesaver, often finding a tumor in its early stages to ensure the best outcome for the patient. There are barriers to mammograms, though, from a lack of health insurance or access to care, to a fear of costs. A new study finds that there may be another reason women forgo mammograms: a stigma over obesity.

Researchers from the University of Sunderland in England recently studied how obesity and its stigma may impact the likelihood of people to get screenings for breast, cervical, and colorectal cancers. The findings, published in the journal Obesity Science and Practice, show that obese women have a lower rate of mammogram uptake and pap smears. The team says that to reverse this trend, health care providers need to be more mindful of their attitudes toward patients.

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Professor Yitka Graham, lead researcher and head of the Helen McArdle Nursing and Care Research Institute, Health Services Research at the University of Sunderland, explains, “Obesity is a known risk factor for the development of cancers. There is also an acknowledged stigma across society toward people living with obesity, which can influence health behaviors and deter seeking help, such as cancer screening. Healthcare professionals’ attitudes and views toward people living with obesity may also affect the patient–professional interface and treatment.”

To conduct their research, Graham’s team reviewed ten prior studies from patient and health care provider perspectives, which focused on screening barriers and challenges, gender issues, and disparities for those living with obesity. They were conducted in the United States, Australia, and Europe.

The team says among the studies they reviewed were one which found that among women aged 50-64, those who were underweight or obese were far less apt to get mammograms than women at a normal weight. This also extended to cervical cancer screening, with obese women less apt to visit a gynecologist regularly, and even if they did visit, they were less apt to get a pap smear than women of a normal weight. It wasn’t just women, though, with the review finding that men of a normal weight are more apt to get colorectal cancer screenings than those who are heavier.

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For women impacted by this barrier, the reasons behind the lack of screenings included negative experiences with past screenings, belief that they were at a lower risk of developing cancer, and body image issues like modesty and self-consciousness.

Kamal Mahawar, co-author and consultant bariatric surgeon at South Tyneside and Sunderland NHS Foundation Trust, says, “The findings of this review show that excess weight is a barrier to accessing cancer screening services for both sexes. The review highlighted the importance of healthcare professionals to understand the concerns and fears of people living with obesity when attending for cancer screening, whether perceived or real – for example, feeling stigmatized – and make every attempt to ensure that facilities are weight-friendly, from equipment, language used, and overall environment.”

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Past studies have shown that many medical professionals may have prejudices against patients with obesity. One study of more than more 200 doctors found that 40+% percent of respondents had a negative reaction toward obese patients, while another study of 620 doctors found that more than half viewed obese patients as awkward, unattractive, or noncompliant.

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