There are 25 million women with disabilities in the United States. They have biologically similar risks to other women for developing all cancers, including gynecologic malignancies. Unfortunately, barriers to comparable cancer screening include lack of knowledge by women themselves, lack of awareness on the part of health care providers about special health concerns clinicians might encounter, and physical access barriers. Together, these factors conspire to delay diagnosis and treatment of many common gynecologic malignancies. Additionally, medications taken by some women with chronic disease states may adversely affect their risk for developing certain types of cancer, and they may be at increased risk for contracting underdiagnosed sexually transmitted diseases linked to cervical cancer. This article describes some important issues regarding incidence and screening for gynecologic malignancies in women with disabilities.
There are nearly 30 million women with disabilities in the United States. Of these, more than 16 million are over the age of 50. Years ago, women with disabilities did not commonly live to the age of menopause, and, if they did, they reached this stage of life in a very debilitated condition. Now, women with disabilities are entering their mature years as active members of society who can look forward to productive futures. Because the health needs of women with disabilities might differ from those of other women, special attention should be focused on how physiological changes of perimenopausal and menopausal states affect this population. In addition to functional changes that might affect menopausal women with disabilities, basic health maintenance issues may be adversely affected by environmental factors. Physical barriers can influence compliance with preventive health screening that is essential in aging populations. Treatment options might need to be tailored to the individual. The disabling condition itself may progress, resulting in secondary conditions requiring creative interventions. A comprehensive evaluation and the development of a suitable management plan, which takes into account the multifactorial nature of aging as a disabled woman, are essential in delivering optimal care to this population.
There are over 28 million women with disabilities in the United States (1). This includes women with mobility and self-care limitations of varying degrees. Many of these women have difficulty obtaining comprehensive, accessible, and dignified physical examinations. Additionally, patients and clinicians are often misinformed about issues pertaining to healthcare needs of women with disabilities (2). This article outlines strategies to overcome physical barriers and gaps in knowledge, and proposes creative solutions for common problems encountered during the performance of the basic physical examination of a woman who has disabilities. It discusses the reality of sexually transmitted disease, promotes awareness of abuse in the population of women with disabilities, and offers guidelines physicians can follow in assisting their patients in resolving this abuse.
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