Stigma leads many obese and overweight patients to avoid cancer screenings


Researchers found that many doctors around the world don’t take a good look at obese patients, an attitude that can affect treatment and screening for breast, cervical and colon cancers. Photo by TeroVesalainen/Pixabay

Many overweight or obese people avoid cancer screening for fear of stigma and judgment about their weight, UK researchers report.

In a review of 10 published studies, the researchers found that many doctors around the world do not look favorably on obese patients, an attitude that can affect the treatment and screening of breast, cervical and colon cancers.

Obesity stigma needs to be challenged and addressed, especially in healthcare settings,” said lead researcher Yitka Graham. She is the head of the Helen McArdle Institute for Nursing and Care Research at the University of Sunderland in the UK.

“The fear of being stigmatized can prevent obese people from accessing Cancer screening services, which are vital for early diagnosis and favorable outcomes,” she said.

Graham said healthcare professionals need to ensure screening services are designed and promoted in a way that encourages obese people to access services without fear of stigma or judgment.

“This has implications for the early clinical interventions needed to diagnose, assess and treat common cancers, resulting in potential adverse outcomes and increased cancer mortality in people with obesity,” she said.

Of the studies reviewed, several found that obese women aged 50 to 64 were less likely to have mammograms than women of normal weight. This disparity was also seen in underweight women, the researchers noted.

Obese women were also less likely to be screened for cervical cancer, the results showed. Additionally, overweight or obese men were less likely than normal-weight men to be screened for colon cancer, Graham’s team found.

Embarrassment, negative body image and problems with imaging equipment were all cited as reasons obese people were less likely to be screened.

Kristen Sullivan, director of nutrition and physical activity at the American Cancer Society, reacted to the findings.

“Unfortunately, weight bias is prevalent in healthcare,” Sullivan said. “But there are things clinicians and health systems can do to reduce it and make obese people feel more comfortable getting screened for cancer.”

Sullivan said doctors and staff should always use “priority” language, such as saying “an obese person” instead of “an obese person.”

“The term ‘obese’ should never be used to describe a patient,” she said. “In addition, waiting rooms, bathrooms and exam rooms should be equipped with furniture and equipment that can accommodate patients of all sizes and abilities.”

Doctors need to understand that obesity is a complex chronic disease and avoid overly simplistic advice like “eat less and move more,” Sullivan said.

“Health care practices should adopt a zero-tolerance policy regarding derogatory jokes or comments about patients,” she said. “These actions can help build trust and respect between a clinician and their patients with obesity.”

Overweight is associated with increased odds to develop 12 types of cancer.

And that includes some of the most common, such as postmenopausal breast cancer and colon cancer. Endometrium, esophagus, kidney, liver, ovary, pancreas, stomach, thyroid, multiple myeloma and meningioma are also cancers associated with obesity, Sullivan said.

“Recommended cancer screenings are critically important for obese people, who may be at higher risk for certain cancers,” she explained.

Although some doctors have biases against overweight or obese patients, many are educating themselves about how to reduce those biases and stereotypes, Sullivan said. But, she says, change takes time.

“In the meantime, overweight or obese people need to be their own advocates,” Sullivan advised. “They can inquire before making an appointment if the facilities and equipment are suitable for patients with larger bodies, or communicate to their current or practice clinician that they should have larger gowns, wider seats in the waiting room, etc. Don’t be afraid to shop around to find a doctor or practice that respects patients of all sizes.”

The report was published online recently in the journal Science and Practice of Obesity.

More information

To learn more about obesity and cancer, visit US National Cancer Institute.

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