Overweight, obesity, and colorectal cancer screening: Disparity between men and women

Background: To estimate the association between body-mass index (BMI:kg/m(2)) and colorectal cancer (CRC) screening among US adults aged greater than or equal to50 years. Methods: Population-based data from the 2001 Behavioral Risk Factor Surveillance Survey. Adults (N=84,284) aged greater than or equal to50 years were classified by BMI as normal weight (18.5-<25), overweight (25-<30), obesity class I (30-<35), obesity class II (35-<40), and obesity class III (greater than or equal to40). Interval since most recent screening fecal occult blood test (FOBT): (0=>1 year since last screening vs. 1=screened within the past year), and screening sigmoidoscopy (SIG): (0=>5 years since last screening vs. 1=within the past 5 years) were the outcomes. Results: Results differed between men and women. After adjusting for age, health insurance, race, and smoking, we found that, compared to normal weight men, men in the overweight ( odds ratio [OR] 1.25, 95% CI=1.05-1.51) and obesity class I (OR=1.21, 95% CI=1.03-1.75) categories were more likely to have obtained a screening SIG within the previous 5 years, while women in the obesity class I (OR=0.86, 95% CI=0.78-0.94) and II (OR=0.88, 95% CI=0.79-0.99) categories were less likely to have obtained a screening SIG compared to normal weight women. BMI was not associated with FOBT. Conclusion: Weight may be a correlate of CRC screening behavior but in a different way between men and women.