Obesity and colorectal cancer screening among black and white adults.

PURPOSE: To examine whether body mass index is associated with reduced colorectal cancer (CRC) screening in a large population of black and white adults.
METHODS: Cross-sectional data collected at baseline for 9,547 black men, 14,515 black women, 3,519 white men, and 7,245 white women aged 50-79 enrolled in the Southern Community Cohort Study from 2002 to 2009 were used to examine odds ratios (OR) with 95 % confidence intervals (CI) for the use of colonoscopy or sigmoidoscopy in relation to body mass index (BMI) categories (<18.5, 18.5-24.9 (referent), 25-29.9, 30-34.9, 35-39.9, and 40+ (extreme obesity), kg/m(2)) using logistic regression controlling for age, education, income, health insurance status, last physician visit, cigarette smoking, and alcohol consumption.
RESULTS: Increased BMI was not associated with reduced CRC screening among whites (OR (95 % CI) for BMI ≥ 40 = 1.02 (0.71-1.46) for white men and 0.99 (0.83-1.19) for white women), and odds of CRC screening were increased with high BMI among blacks (OR (95 % CI) for BMI ≥ 40 = 1.34 (1.03-1.74) for black men and 1.13 (0.98-1.29) for black women). Extreme obesity was associated with reduced odds of CRC screening only among white women in subgroup analyses limited to those with health insurance or income ≥$25,000/year.
CONCLUSIONS: Elevated BMI was not a deterrent to CRC screening overall in this population. In light of low overall screening rates for colorectal cancer nationally, efforts to increase screening in all individuals should remain the focus of public health initiatives.