Christina C. Wee, MD, MPH; Ellen P. McCarthy, PhD; Roger B. Davis, ScD; Russell S. Phillips, MD
Presented in part at the 22nd Annual Meeting of the Society of General Internal Medicine, San Francisco, California, May 1999.
Disclaimer: The analyses, interpretations, and conclusions in this paper are those of the authors and do not reflect those of the National Center for Health Statistics.
Acknowledgments: The authors thank the National Center for Health Statistics for providing the initial data and Erin Hartman for editorial comments.
Grant Support: Dr. Wee and this investigation were supported in part by a grant from the Medical Foundation, Inc. (Boston, Massachusetts), and a National Research Service Award (#1 F32 HS00137-01) from the Agency for Healthcare Research and Quality.
Requests for Single Reprints: Christina C. Wee, MD, MPH, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Libby 330, Boston, MA 02215; e-mail, email@example.com.
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Current Author Addresses: Drs. Wee, McCarthy, Davis, and Phillips: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Libby 330, Boston, MA 02215.
Author Contributions: Conception and design: C.C. Wee, R.S. Phillips.
Analysis and interpretation of the data: C.C. Wee, E.P. McCarthy, R.B. Davis, R.S. Phillips.
Drafting of the article: C.C. Wee, R.S. Phillips.
Critical revision of the article for important intellectual content: C.C. Wee, E.P. McCarthy, R.B. Davis, R.S. Phillips.
Final approval of the article: C.C. Wee, E.P. McCarthy, R.B. Davis, R.S. Phillips.
Statistical expertise: C.C. Wee, E.P. McCarthy, R.B. Davis.
Obtaining of funding: C.C. Wee, R.S. Phillips.
Administrative, technical, or logistic support: C.C. Wee, E.P. McCarthy, R.S. Phillips.
Wee C., McCarthy E., Davis R., Phillips R.; Screening for Cervical and Breast Cancer: Is Obesity an Unrecognized Barrier to Preventive Care?. Ann Intern Med. 2000;132:697-704. doi: 10.7326/0003-4819-132-9-200005020-00003
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Published: Ann Intern Med. 2000;132(9):697-704.
Obese women have higher mortality rates for breast and cervical cancer than do thinner women (1, 2). Obesity also has important social, economic, and psychological consequences, including societal discrimination and poor self-perception (3-8). Whether these consequences influence the quality of medical care received by obese patients is unclear.
Recent studies suggest that obese women receive preventive services, such as Papanicolaou (Pap) smears and clinical breast examinations, less often than normal-weight women (9, 10). Other studies suggest that physicians and other health care providers have negative attitudes toward and biases against obese patients, which may explain some of the disparities in care (11-14). Obese women also seem to have poorer self-esteem and body images than their thinner counterparts (5, 6). Poor self-concept may be influenced by ethnicity (6-8, 15). White women are more likely than black women of similar weight to perceive themselves as overweight (6), and this poor self-perception may influence attitudes toward screening with Pap smears and mammography.
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Hematology/Oncology, Obesity, Breast Cancer, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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