Obesity, body image and past screening experiences : impacts on breast screening participation

![CDATA[Background: Obesity is a growing global health issue and increases risk of chronic diseases, such as breast cancer. Evidence suggests individuals with a higher body mass index (BMI) are less likely to engage in preventative health screens due to self-stigmatisation and poor experiences, despite being at higher risk of chronic disease. Methods: An online survey investigating breast screening participation, body shame and past screening experiences was distributed to women in Australia via targeted social media marketing using Facebook. Descriptive statistics, chi-square tests of independence and generalised linear regression were used to analyse the data. Results: Among the women who completed the survey (n=892), negative past screening experiences were correlated and reduced levels of rescreening (p = 0.0001). Higher BMI was also associated with reduced rescreening (p = 0.007) compared to those with a lower BMI. Increased body shame scores were also linked to negative previous screening experiences (p <0.0001). These data also suggest body image disturbances may be correlated with BMI. Low body shame was associated with higher healthcare seeking scores (p <0.0001). Conclusion: Body image, obesity and past screening experiences influence how women access breast screening programs. Having a higher BMI appears to contribute to negative screening experiences via increased body image shame, both of which may reduce screening among obese women. Consideration of these issues is warranted if screening participation is to be optimised in this group of higher risk women, as well as education for mammographic staff on sensitive handling of obese women.]]