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BMC Health Services Research

Open Access

The effects of obesity and mobility disability in access to breast and cervical cancer screening in France: results from the National Health and Disability Survey

  • Clémence Bussière1,
  • Jonathan Sicsic1 and
  • Nathalie Pelletier-Fleury1
BMC Health Services Research201414(Suppl 2):P13

Published: 7 July 2014


ObesityCervical CancerCancer ScreeningAdjust Odds RatioObese Woman


We aimed to disentangle the effects of obesity and mobility limitation on cervical and breast cancer screening among community dwelling women.


The data source was the French national Health and Disability Survey - Household Section, 2008. The Body Mass Index (BMI) was used to categorize obesity status. We constructed a continuous score of mobility limitations to assess the severity of disability (Cronbach’s alpha=0.84). Logistic regressions were performed to examine the association between obesity, mobility limitations and the use of Pap test (n=8 133) and the use of mammography (n=7 561). Adjusted odds ratios were calculated (AOR).

Interaction terms between obesity and the disability score were included in models testing for effect modifications.


Compared with non-obese women, the odds of having a Pap test in the past 3 years was 24% lower in obese women (AOR=0.76; 95% CI: 0.65 to 0.89), the odds of having a mammogram in the past 2 years was 23% lower (AOR=0.77; 95% CI: 0.66 to 0.91). Each time the disability score was 5 points higher, the odds of having a Pap test decreases by 20% (AOR=0.96; 95% CI: 0.94 to 0.98), the odds of having a mammogram decreases by 25% (AOR=0.95; 95% CI: 0.94 to 0.97). There was no significant interaction between obesity and disability score.


Obesity and mobility limitation are independently associated with a lower likelihood of cervical and breast cancer screening. Protective outreach and follow-up are necessary to reduce inequalities and thus to reduce health disparities in these vulnerable and high-risk populations of obese women with disabilities.

Authors’ Affiliations

CERMES3, INSERM U988, Villejuif, France


© Bussière et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.