Barriers to cancer screening for people with disabilities: A literature review

Merten, Julie Williams; Pomeranz, Jamie L.; King, J. Stanton; Moorhouse, Michael; Wynn, Richmond D.

doi:10.1016/j.dhjo.2014.06.004

Cited by 79 publications

(81 citation statements)

References 46 publications

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“…Several studies have evidenced how people with disabilities experience compromised access to cancer screening services. [31][32][33][34] People with disabilities face structural, financial and cultural/attitudinal barriers when they seek to access healthcare. 35 Difficulties in accessing healthcare can be caused by lack of transport, inaccessible buildings, and inadequate training of healthcare professionals, among other factors.…”

Section: Discussionmentioning

confidence: 99%

“…Barriers in accessing cancer-screening services can lead to lower use of such services compared with the general population, with subsequent delays in diagnosis. 34 Furthermore, the results indicate that cost is a factor that affects use of healthcare, including prescription medication. While NHS Wales, NHS Scotland, and Health and Social Care in Northern Ireland have abolished prescription charges, NHS England, where the majority of the UK population reside and seek to access healthcare services, has not.…”

Section: Discussionmentioning

confidence: 99%

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Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data

Sakellariou

Rotarou

2017

BMJ Open

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ObjectivesThe aim of this study was to investigate differences in access to healthcare between people with and without disabilities in the UK. The hypotheses were that: (1) people with disabilities would be more likely to have unmet healthcare needs and (2) there would be gender differences, with women more likely to report unmet needs.Setting and participantsWe performed secondary analysis, using logistic regressions, of deidentified cross-sectional data from the European Health Interview Survey, Wave 2. The sample included 12 840 community-dwelling people over the age of 16 from across the UK, 5 236 of whom had a disability. The survey method involved face-to-face and telephone interviews.Outcome measuresUnmet need for healthcare due to long waiting lists or distance or transportation problems; not being able to afford medical examination, treatment, mental healthcare or prescribed medicines. All measures were self-reported.ResultsAdjusting for age, sex and other factors, people with a severe disability had higher odds of facing unmet needs. The largest gap was in ‘unmet need for mental healthcare due to cost’, where people with a severe disability were 4.5 times (CI 95% 2.2 to 9.2) more likely to face a problem, as well as in ‘unmet need due to cost of prescribed medicine’, where people with a mild disability had 3.6 (CI 95% 2.2 to 5.9) higher odds of facing a difficulty. Women with a disability were 7.2 times (CI 95% 2.7 to 19.4) more likely to have unmet needs due to cost of care or medication, compared with men with no disability.ConclusionsPeople with disabilities reported worse access to healthcare, with transportation, cost and long waiting lists being the main barriers. These findings are worrying as they illustrate that a section of the population, who may have higher healthcare needs, faces increased barriers in accessing services.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data

Sakellariou

Rotarou

2017

BMJ Open

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“…5 Changes in the types of tests used to detect colorectal cancers over time can complicate these analyses. 6 Those studies that have compared colorectal screening for disabled and nondisabled populations have sometimes produced somewhat surprising findings.…”

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confidence: 99%

“…These findings are surprising because of the physical demands of some colorectal cancer screening tests, 5,9 particularly the bowel preparation required before colonoscopy. In a qualitative study of primary care and persons with disabilities, some interviewees with significant physical disability mentioned this concern.…”

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confidence: 99%

Trends in colorectal cancer screening over time for persons with and without chronic disability

Iezzoni

Kurtz²,

Rao

2016

Disability and Health Journal

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Background Persons with disabilities have often experienced disparities in routine cancer screening. However, with civil rights protections from the 1990 Americans with Disabilities Act, such disparities may diminish over time. Objective To examine whether disability disparities exist for colorectal cancer screening and whether these screening patterns have changed over time. Methods We analyzed National Health Interview Survey responses from civilian, non-institutionalized U.S. residents 50–75 years old from selected years between 1998 and 2010. We specified 7 chronic disability indicators using self-reported functional impairments, activity/participation limitations, and expected duration. Separately for women and men, we conducted bivariable and multivariable logistic regression analyses examining associations of self-reported colorectal cancer screening services with sociodemographic factors and disability type. Results Patterns of chronic disability differed somewhat between women and men; disability rates generally rose over time. For both women and men, colorectal cancer screening rates increased substantially from 1998 through 2010. Over time, relatively few statistically significant differences were reported in colorectal cancer screening rates between nondisabled persons and individuals with various disabilities. In 2010, reported screening rates were generally comparable between nondisabled and disabled persons. In the few statistically significant differences, persons with disabilities almost always reported higher colorectal cancer screening rates than nondisabled individuals. Conclusions According to national survey data, reported use of colorectal cancer screening is similar between nondisabled persons and individuals with a variety of different disability types. Despite physical demands of some colorectal cancer screening tests, disparities do not appear between populations with and without disability.

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“…In addition, adults with IDD are experiencing longer life expectancies (Thomas & Barnes, 2010). Despite these gains, adults with IDD still experience health disparities, with higher rates of chronic conditions, comorbid mental health conditions, and lower rates of preventive care than the general U.S. adult population (Croen, Zerbo, Ouian, & Massolo, 2014;Krahn, Walker, & Correa-DeAraujo, 2015;Merten, Pomeranz, King, Moorhouse, & Wynn, 2015). The health disparities experienced by adults with IDD are resulting in an increased focus on ways to improve access to care and care coordination to promote better health and wellness (Krahn et al, 2015).…”

Section: Introductionmentioning

confidence: 98%

Implementation of Medicaid Managed Long-Term Services and Supports for Adults With Intellectual and/or Developmental Disabilities in Kansas

Williamson

Perkins

Levin

et al. 2017

Intellectual and Developmental Disabilities

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Many adults with intellectual and/or developmental disabilities (IDD) can access health and long-term services and supports (LTSS) through Medicaid. States are reforming their Medicaid LTSS programs from a fee-for-service model to a Medicaid managed LTSS (MLTSS) approach, anticipating improved quality of care and reduced costs, although there is limited evidence of MLTSS effectiveness. This study's objective was to contribute to the growing MLTSS research literature by describing MLTSS implementation in Kansas for adults with IDD. Thirty-one stakeholders completed in-depth semi-structured interviews, representing state or regional groups, service coordination providers, and family caregivers. Findings identify key aspects of the Centers for Medicare and Medicaid Services' new MLTSS regulations in the design and implementation of MLTSS programs.

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Barriers to cancer screening for people with disabilities: A literature review

Cited by 79 publications

References 46 publications

Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data

Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data

Trends in colorectal cancer screening over time for persons with and without chronic disability

Implementation of Medicaid Managed Long-Term Services and Supports for Adults With Intellectual and/or Developmental Disabilities in Kansas

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