Obesity and recent mammography use among black and white women in the Southern Community Cohort Study (United States)

Objective To examine the relationship between obesity and mammography use in a large population of black and white women. Methods Baseline data from 18,756 black and 6,304 white women enrolled in the Southern Community Cohort Study were used to examine the association between body mass index categories (healthy weight: 18.5-24.9 kg/m(2), overweight: 25-29.9 kg/m(2), and obesity classes I: 30-34.9 kg/m(2), II: 35-39.9 kg/m(2), and III: 40+ kg/m(2)) and mammogram use in the past two years. Cross-sectional analyses were conducted using logistic regression controlling for socioeconomic measures, medical conditions, insurance coverage, and lifestyle factors. Results Among white women, obesity class III was associated with a reduced likelihood of recent mammography compared to healthy weight women (OR = 0.70, 95% CI 0.56-0.87) that appeared unrelated to income and insurance coverage. A deterring effect of obesity was not evident among black women; instead, overweight and obesity were associated with small elevations in mammography use compared to healthy weight. Conclusions In light of rising obesity rates and known associations between obesity and breast cancer risk and prognosis, a deterring effect of extreme obesity on mammography screening for white women is a concern that should be addressed by screening programs and by further directed research into the factors underlying this association.