The Association of Cervical Cancer Screening With Disability Type Among U.S. Women (Aged 25-64 Years).

INTRODUCTION: Despite a gradual decline in cervical cancer mortality because of greater use of screening, including Pap and human papillomavirus (HPV) tests, disparities in screening among adult women by disability type have not been examined. This study aims to assess the odds of cervical cancer screening using HPV tests by disability type among U.S. women aged 25-64 years. METHODS: This study was analyzed in 2022 using pooled data from 2018 and the 2020 Behavioral Risk Factor and Surveillance System. The analytic sample included 189,795 women aged 25-64 years. Disability was defined as having any sensory disability, cognitive disability, physical disability, ≥2 disabilities, or no disability adapted from a standardized questionnaire. Descriptive analyses were used to estimate the proportion of HPV tests on the basis of 2020 American Cancer Society guidelines, which recommend testing within five years for all women aged 25-65 years. Multivariable analyses were conducted to estimate AORs of cervical cancer screening by disability type. RESULTS: Overall, 53.8% of women met recommended 2020 American Cancer Society guidelines for cervical cancer screening using HPV tests. The proportion of HPV tests was higher in women with a cognitive disability (55.9%) and lower in those with sensory (49.7%), physical (48.2%), and ≥2 disabilities (47.8%) than in those without disabilities (54.8%). In adjusted analyses, women with any disability (AOR=0.95, 95% CI=0.88, 0.97), physical disability (AOR=0.96, 95% CI=0.80, 0.98), and ≥2 disabilities (AOR=0.88, 95% CI=0.78, 0.97) had lower odds of receiving cervical cancer screening with HPV testing than women without disabilities. CONCLUSIONS: Disparities in screening with HPV tests among women with physical and ≥2 disabilities suggest the need for a targeted approach to improve prevention screening awareness, access, and availability in this population.

Assessing Disparities in Cervical Cancer Screening with Pap Test by Disability Types.

Prior research has found that women with disabilities have often experienced disparities in receipt of cervical cancer screening. However, there is a research gap regarding receipt of cervical cancer screening by types of disability. This study examined the differences in receiving cervical cancer screening through self-reported Pap testing among women by disability type. This cross-sectional study analyzed data from the 2016, 2018, and 2020 Behavioral Risk Factor and Surveillance System (BRFSS). The relative risk of cervical cancer screening through self-reported Pap tests received within the past three years among women aged 21-65 by disability type was compared using modified Poisson regression with robust error variance. A total of 307,142 women from across the USA were sampled. In every disability group, older women were significantly less likely to receive Pap tests than their counterparts without disabilities. Women with multiple disabilities (aRR=0.91; 95% CI, 0.89-0.94) and those with ambulatory disabilities (aRR=0.93; 95% CI, 0.91-0.97) reported being less likely to receive Pap tests than women with no disability. Ambulatory disability and multiple disabilities are associated with a lower likelihood of cervical cancer screening with Pap test, increasing the need to eliminate disability-specific disparities in Pap testing. Future efforts should focus on improving cancer education programs tailored to the needs of women with disabilities, addressing barriers related to mobility and access to healthcare services, and ensuring equitable access to preventive screenings.

Disparities in Cervical Cancer Screening by Disability Types: a Systematic Review.

Previous studies showed that the receipt of cervical cancer screening among women with disabilities is low. Some disparities may also exist within the subpopulation of women with disabilities. This systematic review synthesized the current literature on the receipt of cervical cancer screening by disability type. PubMed, ProQuest, EBSCO, PsycINFO, MEDLINE, and Google Scholar searches were performed to identify studies between April 2012 and January 2022. A total of ten studies met the inclusion criteria and were included in this review. All studies employed a cross-sectional approach (n = 10) and most used multivariable logistic regression (n = 7). Two of the ten articles included classified disability types as basic action difficulties and complex activities, while eight of the articles classified it as either hearing, vision, cognitive, mobility, physical, functional, language disability, or autism. The association between disability types and cervical cancer screening was inconsistent across publications. All the studies except for one however indicated that evidence of lower screening rates exists within the subpopulation of women with disability. The available evidence supports the conclusion that disparities in cervical cancer screening are evident in disability subgroups; however, evidence is inconsistent regarding which disability type experiences lower receipt of screening. Screened articles utilized different definitions for disability adding to the inconsistency in the results. More focused research using a standardized definition for disability is required to determine which disability type experiences significant disparities in cervical cancer screening. This review highlights the need for healthcare organizations to target specific tailored interventions to improve the quality of care for specific disability subgroups.

Racial disparities in routine health checkup and adherence to cancer screening guidelines among women in the United States of America.

PURPOSE: Routine health checkup and cancer screening rates among women are suboptimal, partially due to the health care disparities by race/ethnicity in the USA. This study examined the previously understudied associations between routine health checkup, cervical cancer screening, and breast cancer screening by race/ethnicity using the national representative sample of women. METHODS: Data were obtained from three cycles (2017, 2018, and 2019) of the Health Information National Trends Survey (HINTS) (n = 12,227). Survey-weighted logistic regressions were evaluated to assess associations between routine health checkup and cervical and breast cancer screening compliance with the established guidelines with the age criteria and frequency of screening by race/ethnicity (Black, White, Hispanic, and Other). RESULTS: This study included 6,941 women in the cervical cancer screening and 8,005 women for breast cancer screening, considering the age criteria. Women who had received routine health checkups were more likely to meet the cervical cancer screening guideline (Odds ratio 3.24, p < 0.05) and breast cancer screening guideline (OR 5.86, p < 0.05) compared to women who did not receive routine health checkups. While routine health checkups were associated with both types of cancer screenings in most racial/ethnic groups, analyses stratified by race/ethnicity suggest that Hispanic women and Other women did not benefit from routine health checkup in relation to cervical and breast cancer screening, respectively. CONCLUSION: Promotion of routine health checkups could promote cancer screening among women across racial/ethnic groups, although specific racial/ethnic groups may require additional support.