Adams C H, Smith N J, Wilbur D C, Grady K E
University of Connecticut, Storrs 06269.
Women Health. 1993;20(2):45-57. doi: 10.1300/J013v20n02_04.
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.
肥胖女性患子宫内膜癌和卵巢癌的风险更高。生化机制是已被证实的致病因素，但心理社会态度的作用却很少受到关注。本研究调查了肥胖女性与非肥胖女性盆腔筛查检查频率的差异，以及医生和患者对肥胖的态度对检查频率的影响。共有291名女性受试者和1316名医生受试者参与了本研究。本文报告的数据表明，态度和行为会受到体重的负面影响。随着受试者体重的增加，对其外貌的负面评价以及不愿接受盆腔检查的情况也会增加，而进行年度盆腔检查的可能性则会降低。相当一部分少数医生（17%）和绝大多数医生（83%）表示，他们分别不愿为肥胖患者和不愿接受检查的患者进行盆腔检查。如果医生更不愿为肥胖且不愿接受检查的女性进行盆腔检查，而肥胖女性又更不愿接受检查，那么在检测女性生殖道腺癌方面可能会出现严重延误。
