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Prevalence of Cancer Screening Among Adults With Disabilities, United States, 2013
C Brooke Steele1, Julie S Townsend2, Elizabeth A Courtney-Long3
1Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F76, Atlanta, GA 30341.
Introduction:
Many 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.
Methods:
We 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).
Results:
Reported 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.
Conclusion:
We 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.
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