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Cancer screening disparities found among patients with disabilities varied by type

While patients with disabilities were more likely to receive some form of cancer screening vs. patients without disabilities, disparities in the receipt of cancer screening varied by disability type and limitations, according to results published in Preventing Chronic Disease.

“Our research found that women whose doctor recommended a Pap test or a mammogram were more likely to get the test, whether or not they had a disability. But women with a disability were still less likely to get tested than women without a disability,” C. Brooke Steele, DO, division of Cancer Prevention and Control, CDC, told Healio Family Medicine.

C. Brooke Steele

She also noted that their research uncovered the most common barrier patients with disabilities may face when getting the screenings.   

The researchers analyzed 2013 National Health Interview Survey data, focusing on information from 15,079 adults aged 21 to 75 with known disability status. Of those, 2,580 (16.9%) had one or more of the following disabilities: hearing, vision, cognition and/or mobility. Demographic variables such as general health and marital status, education level, sex and race were also included.

Steele and colleagues reported that 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, when compared to the other variables researchers considered such as lack of transportation, inconvenient clinician hours, long wait times, difficulties reaching staff by phone and a person’s health insurance status. In addition, the rate of colorectal cancer screenings was 57% among persons without disabilities, and ranged from 48.6% (95% CI, 40.3-57) among those with vision limitations to 64.6% (95% CI, 58.5-70.2) among those with hearing limitations. Pap test use ranged from 66.1% (95% 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, 80-82.7) among women without disabilities. Frequency of mammography among women with disabilities ranged from 61.2% (95% CI, 50.5-71) to 67.5% (95% CI, 62.8-71.9) compared with women without disabilities (95% CI, 70.7-74.9).

Steele stated that people with disabilities face many barriers to good health, and are more likely than people without disabilities to engage in health behaviors that increase cancer risk such as cigarette smoking and physical inactivity. She offered tips primary care physicians can use to ensure more patients with disabilities get screened for cancer.

“Communicate clearly and directly. If your patient does not understand your questions or instructions, repeat what you have said, use other words, or find another way to provide the information. Ensure that information about cancer screening is posted where it can be easily seen by patients, or provided in alternate formats such as large print,” she said. “Consider using automated reminders for cancer screening in your electronic health record systems. When scheduling screening appointments, let scheduling staff and radiology technicians know whether the patient may need assistance sitting upright, lifting and moving [their] arms, transferring from [their] chair/scooter, or undressing/dressing. Keep in mind that patients with disabilities may need additional time for their screening examinations.” – by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.