Body mass index and use of mammography screening in the United States

Background. Obese and underweight women may be less likely to seek cancer screening because of health status, self-perception, and body image related to non-desirable weight. This study examined the relationship between body mass index (BMI) and mammography screening, using the data from the year 2000 United States National Health Interview Survey. Methods. This study included 7692 white and 1496 black female participants aged 40–80, who were randomly selected. Body mass index (kg/m2), based on self-reported weight and height, was compared between women with and without a mammogram in the past 2 years using logistic regression. Results. Compared to women with normal body mass index, underweight and extremely obese women were more likely to have no screening mammograms in the past 2 years (odds ratio (OR) = 1.8, 95% confidence interval (CI), 1.2–2.6 for underweight women; odds ratio = 1.3, 95% confidence interval, 1.0–1.8 for extremely obese women). When data were analyzed by race, the odds ratio estimates were 1.8 for underweight white women (95% confidence interval, 1.3–2.7) and 1.4 for extremely obese white women (95% confidence interval, 1.0–1.9). The corresponding odds ratio estimates were close to 1.0 for black women. Conclusions. Underweight and extreme obesity may increase the risk of underusing screening mammography. The association between body mass index especially underweight and underuse of mammography might exist primarily in white women.