Cancer Screening Patterns by Weight Group and Gender for Urban African American Church Members

Obese white women have lower rates of cancer screening compared to non-obese women. This study will determine if a relationship
exists between weight and adherence to cancer screening guidelines among African Americans. We used multivariate logistic
regression to examine the relationship between being up-to-date with cancer screening (colorectal, breast, cervical, and prostate)
and weight group (normal, overweight, obese I, obese II+) using data from older (age 50+) members (N = 955) of 20 African
American churches in Michigan and North Carolina. CRC testing rates were examined using multiple definitions to account for
differences in screening rates vs. polyp surveillance rates. After adjusting for confounders, we found relationships between
weight group and up-to-date CRC (P = 0.04) and PSA (P = 0.004) testing for men and mammography (P = 0.03) for women. Compared to normal-weight men, obese I men were more likely to be up-to-date with CRC (OR 2.35, 95%CI
1.02–5.40) and PSA (OR 4.24 95%CI 1.77–10.17) testing. CRC screening rates were lower when individuals with polyps were excluded
from the analysis; however, patterns by weight remained the same. Contrary to previous research, we did not find lower rates
of cancer screening among obese African Americans. Instead, we found that normal-weight African American men had lower screening
rates than any other group. As we did not consistently find lower screening rates among obese African Americans, targeting
this group for increased screening promotion may not be the most effective way to reduce weight-related cancer disparities.