Impact of body mass index and examination type on utilization of screening programs: A big data study

To investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering longitudinal changes in weight and the type of screening. Data from Clalit Health Services in Israel were...

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Veröffentlicht in:	Preventive medicine Jg. 185; S. 108045
Hauptverfasser:	Udi, Yarin, Gilad-Bachrach, Ran, Cohen, Hilla, Sagi-Dain, Lena
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Elsevier Inc 01.08.2024
Schlagworte:	Aged Big Data Body Mass Index Cancer screening Female Humans Internal Medicine Israel Male Mass Screening - statistics & numerical data Middle Aged Obesity Obesity - diagnosis Obesity - epidemiology Overweight - epidemiology Patient Acceptance of Health Care - statistics & numerical data Patient-doctor communication Physical Examination - statistics & numerical data Preventive medicine Retrospective Studies Weight stigma Israel Obesity Patient-doctor communication Preventive medicine Weight stigma Cancer screening
ISSN:	0091-7435, 1096-0260, 1096-0260
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Abstract	To investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering longitudinal changes in weight and the type of screening. Data from Clalit Health Services in Israel were retrospectively analyzed, including participants aged 50 and above from 2002 to 2021. BMI measurements and various screening test records were examined. Generalized Estimating Equations were employed for analysis, adjusting for potential confounding variables, including age, gender, geographic location, and socioeconomic status. The study included 634,879 participants with 4,630,030 BMI measurements and 56,453,659 test records. Participants were categorized into BMI cohorts at the time of the test, with overweight and obese individuals showing lower odds of undergoing intimate examination-based screening tests (mammography, PAPS, and skin examination), as opposed to higher odds of several non-intimate tests (e.g., diabetes and eye disorder screenings). Our findings suggest that individuals with overweight and obesity are less likely to undergo screenings involving intimate physical examinations, potentially due to weight stigma and discomfort. This avoidance behavior may contribute to increased morbidity rates in these populations. Interventions addressing weight stigma, improving access to care, and enhancing patient engagement are warranted.
AbstractList	To investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering longitudinal changes in weight and the type of screening. Data from Clalit Health Services in Israel were retrospectively analyzed, including participants aged 50 and above from 2002 to 2021. BMI measurements and various screening test records were examined. Generalized Estimating Equations were employed for analysis, adjusting for potential confounding variables, including age, gender, geographic location, and socioeconomic status. The study included 634,879 participants with 4,630,030 BMI measurements and 56,453,659 test records. Participants were categorized into BMI cohorts at the time of the test, with overweight and obese individuals showing lower odds of undergoing intimate examination-based screening tests (mammography, PAPS, and skin examination), as opposed to higher odds of several non-intimate tests (e.g., diabetes and eye disorder screenings). Our findings suggest that individuals with overweight and obesity are less likely to undergo screenings involving intimate physical examinations, potentially due to weight stigma and discomfort. This avoidance behavior may contribute to increased morbidity rates in these populations. Interventions addressing weight stigma, improving access to care, and enhancing patient engagement are warranted. AbstractObjectiveTo investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering longitudinal changes in weight and the type of screening. MethodsData from Clalit Health Services in Israel were retrospectively analyzed, including participants aged 50 and above from 2002 to 2021. BMI measurements and various screening test records were examined. Generalized Estimating Equations were employed for analysis, adjusting for potential confounding variables, including age, gender, geographic location, and socioeconomic status. ResultsThe study included 634,879 participants with 4,630,030 BMI measurements and 56,453,659 test records. Participants were categorized into BMI cohorts at the time of the test, with overweight and obese individuals showing lower odds of undergoing intimate examination-based screening tests (mammography, PAPS, and skin examination), as opposed to higher odds of several non-intimate tests (e.g., diabetes and eye disorder screenings). DiscussionOur findings suggest that individuals with overweight and obesity are less likely to undergo screenings involving intimate physical examinations, potentially due to weight stigma and discomfort. This avoidance behavior may contribute to increased morbidity rates in these populations. Interventions addressing weight stigma, improving access to care, and enhancing patient engagement are warranted. To investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering longitudinal changes in weight and the type of screening.OBJECTIVETo investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering longitudinal changes in weight and the type of screening.Data from Clalit Health Services in Israel were retrospectively analyzed, including participants aged 50 and above from 2002 to 2021. BMI measurements and various screening test records were examined. Generalized Estimating Equations were employed for analysis, adjusting for potential confounding variables, including age, gender, geographic location, and socioeconomic status.METHODSData from Clalit Health Services in Israel were retrospectively analyzed, including participants aged 50 and above from 2002 to 2021. BMI measurements and various screening test records were examined. Generalized Estimating Equations were employed for analysis, adjusting for potential confounding variables, including age, gender, geographic location, and socioeconomic status.The study included 634,879 participants with 4,630,030 BMI measurements and 56,453,659 test records. Participants were categorized into BMI cohorts at the time of the test, with overweight and obese individuals showing lower odds of undergoing intimate examination-based screening tests (mammography, PAPS, and skin examination), as opposed to higher odds of several non-intimate tests (e.g., diabetes and eye disorder screenings).RESULTSThe study included 634,879 participants with 4,630,030 BMI measurements and 56,453,659 test records. Participants were categorized into BMI cohorts at the time of the test, with overweight and obese individuals showing lower odds of undergoing intimate examination-based screening tests (mammography, PAPS, and skin examination), as opposed to higher odds of several non-intimate tests (e.g., diabetes and eye disorder screenings).Our findings suggest that individuals with overweight and obesity are less likely to undergo screenings involving intimate physical examinations, potentially due to weight stigma and discomfort. This avoidance behavior may contribute to increased morbidity rates in these populations. Interventions addressing weight stigma, improving access to care, and enhancing patient engagement are warranted.DISCUSSIONOur findings suggest that individuals with overweight and obesity are less likely to undergo screenings involving intimate physical examinations, potentially due to weight stigma and discomfort. This avoidance behavior may contribute to increased morbidity rates in these populations. Interventions addressing weight stigma, improving access to care, and enhancing patient engagement are warranted.
ArticleNumber	108045
Author	Cohen, Hilla Udi, Yarin Gilad-Bachrach, Ran Sagi-Dain, Lena
Author_xml	– sequence: 1 givenname: Yarin surname: Udi fullname: Udi, Yarin organization: Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv, Israel – sequence: 2 givenname: Ran surname: Gilad-Bachrach fullname: Gilad-Bachrach, Ran organization: Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv, Israel – sequence: 3 givenname: Hilla surname: Cohen fullname: Cohen, Hilla organization: Research Authority, Clalit Health Care Organization, Carmel Medical Center, Haifa, Israel – sequence: 4 givenname: Lena surname: Sagi-Dain fullname: Sagi-Dain, Lena email: lena.s@technion.ac.il organization: Genetics Institute, Obstetrics and Gynecology department, Carmel Medical Center, affiliated to the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Keywords	Obesity Patient-doctor communication Preventive medicine Weight stigma Cancer screening
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SubjectTerms	Aged Big Data Body Mass Index Cancer screening Female Humans Internal Medicine Israel Male Mass Screening - statistics & numerical data Middle Aged Obesity Obesity - diagnosis Obesity - epidemiology Overweight - epidemiology Patient Acceptance of Health Care - statistics & numerical data Patient-doctor communication Physical Examination - statistics & numerical data Preventive medicine Retrospective Studies Weight stigma
Title	Impact of body mass index and examination type on utilization of screening programs: A big data study
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