Prevalence of Cancer Screening Among Adults With Disabilities, United States, 2013

Abstract

IntroductionMany studies on cancer screening among adults with disabilities examined disability status only, which masks subgroup differences. We examined prevalence of receipt of cancer screening tests by disability status and type.MethodsWe used 2013 National Health Interview Survey data to assess prevalence of 1) guideline-concordant mammography, Papanicolaou (Pap) tests, and endoscopy and stool tests; 2) physicians’ recommendations for these tests; and 3) barriers to health-care access among adults with and without disabilities (defined as difficulty with cognition, hearing, vision, or mobility).ResultsReported Pap test use ranged from 66.1% (95% confidence interval [CI], 60.3%–71.4%) to 80.2% (95% CI, 72.4%–86.2%) among women with different types of disabilities compared with 81.4% (95% CI, 80.0%–82.7%) among women without disabilities. Prevalence of mammography among women with disabilities was also lower (range, 61.2% [95% CI, 50.5%–71.0%] to 67.5% [95% CI, 62.8%–71.9%]) compared with women without disabilities (72.8% [95% CI, 70.7%–74.9%]). Screening for colorectal cancer was 57.0% among persons without disabilities, and ranged from 48.6% (95% CI, 40.3%–57.0%) among those with vision limitations to 64.6% (95% CI, 58.5%–70.2%) among those with hearing limitations. Receiving recommendations for Pap tests and mammography increased all respondents’ likelihood of receiving these tests. The most frequently reported barrier to accessing health care reported by adults with disabilities was difficulty scheduling an appointment.ConclusionWe observed disparities in receipt of cancer screening among adults with disabilities; however, disparities varied by disability type. Our findings may be used to refine interventions to close gaps in cancer screening among persons with disabilities.

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

“…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. 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).…”

Colonoscopy and Sigmoidoscopy Use among the Average-Risk Population for Colorectal Cancer: A Systematic Review and Trend Analysis

“…Among them, 72 qualified for full-text screening and 23 were considered eligible for the review. Fourteen reports provided estimates for the US (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38). The other studies were conducted in Australia (one study; ref.…”

“…Three studies provided nationally representative estimates (based on NHIS; refs. 25,32,33) and another three only included specific ethnic groups [Chinese or Chinese Americans (27), African Americans (30) and Koreans (35)].…”

The social construction of disability and the capabilities approach: Implications for nursing

“…For example, adults with disabilities are far less likely to receive important preventive screenings for cancer including mammograms and prostate checks or to have regular dental checkups. [26][27][28] Further, evidence indicates that professionals across the healthcare spectrum hold negative and stigmatizing attitudes toward PWD. 29,30 PWD also face inaccessible medical offices and examination equipment as well as office policies that prevent them from receiving adequate and accessible healthcare communications.…”