The relationship of obesity to the frequency of pelvic examinations: do physician and patient attitudes make a difference?

Obese women are at higher risk for the development of both endometrial and ovarian carcinoma. Biochemical mechanisms represent documented causal factors but the role of psycho-social attitudes has received limited attention. This study examined the difference in the frequency of pelvic screening examinations between obese and non-obese women and the effect of physician and patient attitudes toward obesity on examination frequency. A total of 291 women subjects and 1316 physician subjects participated in this study. Data reported in this paper suggest that attitudes and behaviors are negatively influenced by weight. As subjects' weight went up, negative opinions about their appearance and reluctance to obtain pelvic examinations also increased while the likelihood of having annual pelvic examinations decreased. A substantial minority (17%) and an overwhelming majority (83%) of physicians indicated they were reluctant to perform pelvic examinations on obese and reluctant patients respectively. If physicians are more reluctant to perform pelvic examinations on obese and reluctant women and obese women are more reluctant to be examined, there may be a critical delay in detecting adenocarcinomas of the female genital tract.