Disability and participation in breast and bowel cancer screening in England: a large prospective study

Abstract

Background:There is limited information about participation in organised population-wide screening programmes by people with disabilities.Methods:Data from the National Health Service routine screening programmes in England were linked to information on disability reported by the Million Women Study cohort participants.Results:Of the 473 185 women offered routine breast or bowel cancer screening, 23% reported some disability. Women with disabilities were less likely than other women to participate in breast cancer screening (RR=0.64, 95% CI: 0.62–0.65) and in bowel cancer screening (RR=0.75, 0.73–0.76). Difficulties with self-care or vision were associated with the greatest reduction in screening participation.Conclusion:Participation in routine cancer screening programmes in England is reduced in people with disabilities and participation varies by type of disability.

Breast cancer screening disparities between women with and without disabilities: A national database study in South Korea

“…Last, the findings of the current study might not be generalizable outside of the current Korean health care system. However, we believe these results provide important insight for other health systems providing organized cancer screening programs or free preventive care services …”

“…However, we believe these results provide important insight for other health systems providing organized cancer screening programs or free preventive care services. 17,36 Despite the availability of the NCSP and the absence of cost barriers, significant disparities were found in breast cancer screening participation, especially among women with severe disabilities and women with brain-related and/or mental disabilities. Although the use of breast cancer screening has increased in women with disabilities over the past decade, the growing disparity gap is a worrisome phenomenon.…”

“…8 However, despite the introduction of legislation to promote equal access to health care and preventive services, to our knowledge disparities with regard to disabilities have been relatively underrecognized, 9 and the goal of such initiatives is far from being achieved. 10 Cancer April 1, 2020 In many studies, women with disabilities have been shown to receive breast cancer screening at a lower rate compared with women without disabilities, [11][12][13][14][15][16][17][18] with few exeptions. 19 However, to the best of our knowledge, the majority of previous studies from the United States used cross-sectional survey data and had the following limitations: 1) use of self-report or proxy-reported disability (including disability type and severity), which is not based on objective clinical assessment; 2) use of self-report or proxy-reported breast cancer screening practices, which is subject to recall bias and fails to distinguish between tests performed for screening purposes and those tests conducted for diagnosis [11][12][13][14]16,19,20 ; and 3) inadequate sample size to yield stable participation rates across various types and severity of disabilities.…”

“…19 However, to the best of our knowledge, the majority of previous studies from the United States used cross-sectional survey data and had the following limitations: 1) use of self-report or proxy-reported disability (including disability type and severity), which is not based on objective clinical assessment; 2) use of self-report or proxy-reported breast cancer screening practices, which is subject to recall bias and fails to distinguish between tests performed for screening purposes and those tests conducted for diagnosis [11][12][13][14]16,19,20 ; and 3) inadequate sample size to yield stable participation rates across various types and severity of disabilities. 11,12,15,17,19,20 One prospective cohort study from England overcame some of the limitations of previous studies, but still involved self-reported disability status (although severity information was lacking). 17 In addition, data demonstrating the temporal trends in breast cancer screening in relation to recent legal acts mandating equitable access to medical care remain scarce.…”

“…11,12,15,17,19,20 One prospective cohort study from England overcame some of the limitations of previous studies, but still involved self-reported disability status (although severity information was lacking). 17 In addition, data demonstrating the temporal trends in breast cancer screening in relation to recent legal acts mandating equitable access to medical care remain scarce. 21 In Korea, universal health coverage is provided to all people through the National Health Insurance and Medical Aid regardless of income level or health risk.…”