根据肥胖状况坚持乳腺癌和宫颈癌筛查指南：法国横断面多中心调查

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI:10.1016/j.pmedr.2026.103405

Elise Foucault , Valérie Macioce , Marion Soler , Yves-Marie Pers , Jean-Baptiste Bonnet , Antoine Avignon , Nicolas Chevalier , Ariane Sultan

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引用次数: 0

摘要

目的评价女性体重指数（BMI）对乳腺癌和宫颈癌的筛查率。方法本横断面研究采用匿名自我填写的问卷，对2020-2021年来自法国三所大学医院的体重正常（BMI 18.5-25 kg/m2）、I级肥胖（BMI 30-35 kg/m2）或II级肥胖（BMI≥35 kg/m2）的女性进行问卷调查。最新筛查是根据国家指南定义的：50-74岁的女性每两年进行一次临床乳房检查和乳房x光检查，25-65岁的女性每三年进行一次宫颈样本检查，但既往患有癌症或相关手术的女性除外。BMI组的筛查率和妇科随访比较。结果439名女性中（ⅰ类肥胖占20%，ⅱ类肥胖占22%），分别有178名和370名符合乳腺癌和宫颈癌筛查要求。I类和II类肥胖妇女接受临床乳腺检查（比值比[95%置信区间]分别为2.35[1.06,5.20]和2.68[1.12,6.42]）、乳房x光检查（比值比[95%置信区间]分别为4.43[1.49,13.18]和4.08[1.22,13.62]）和宫颈检查（比值比[2.23][1.09,4.54]和2.85[1.42,5.72]）的可能性较小。II类肥胖与全科医生更频繁的随访相关（p < 0.05）。结论肥胖女性接受推荐妇科癌症筛查的可能性低于体重正常的女性。这些差异要求制定更具包容性的卫生保健战略。试验注册：NCT04357652。

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Adherence to breast and cervical cancer screening guidelines according to obesity status: a French cross-sectional multicenter survey

Objective

To assess breast and cervical cancer screening rates among women according to body mass index (BMI).

Methods

This cross-sectional study used anonymous self-administered questionnaires given to women from three French university hospitals with normal weight (BMI 18.5–25 kg/m²), class I obesity (BMI 30–35 kg/m²), or class II obesity (BMI ≥ 35 kg/m²) in 2020–2021. Up-to-date screening was defined according to national guidelines: biennial clinical breast exams and mammograms for women aged 50–74, and triennial cervical samples for women aged 25–65, excluding those with prior cancer or related surgery. Screening rates and gynecological follow-up were compared across BMI groups.

Results

Among 439 women (20% class I, 22% class II obesity), 178 and 370 were eligible for breast and cervical cancer screening, respectively. Women with class I and II obesity were less likely to be up-to-date for clinical breast exams (Odds Ratio [95% confidence interval] 2.35[1.06,5.20] and 2.68[1.12,6.42], respectively), mammography (4.43[1.49,13.18] and 4.08[1.22,13.62]), and cervical samples (2.23[1.09,4.54] and 2.85[1.42,5.72]). Class II obesity was associated with more frequent follow-up by general practitioners (p < 0.05).

Conclusions

Women with obesity are less likely to receive recommended gynecological cancer screenings than normal-weight peers. These disparities call for more inclusive healthcare strategies.

Trial registration: NCT04357652.

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