Screening Issues in Gynecologic Malignancies for Women with Disabilities: Critical Considerations

Abstract

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.

Variation in the Cervical Cancer Screening Compliance among Women with Disability

“…One reason could be that the health care providers may have the misconception that women with disabilities are asexual and therefore are at little risk of cervical cancer. 3,4,8,9 Secondly, a Pap smear test requires the patient to lie on an examination table and this could be difficult for some of these disabled women. 4 Furthermore, as many speculate that increasing physician availability may increase the early detection of cancers, 18,20 we examined the relationship between physician availability and routine Pap smear screening.…”

Factors Associated with Self-Reported Mammography Use for Women With and Women Without a Disability

“…Empirical evidence has shown that women with disabilities diagnosed with early stage breast cancer may have lower rates of breast conserving surgery and higher breast cancer mortality than women without a disability. 7 Although women with a disability share the same risk for breast cancer as women without a disability, 8 they are less likely to obtain a mammogram at recommended screening intervals. [9][10][11] However, these studies examining mammography use among women with a disability use either national data collected in the mid-1990s that is now dated 9,11 or small, not nationally representative samples.…”

Barriers and strategies affecting the utilisation of primary preventive services for people with physical disabilities: a qualitative inquiry

“…Several researchers have found disparities in the receipt of preventive services, but results vary with severity of disability and access to physical exams (Diab & Johnston 2004), type of insurance (Sutton & DeJong 1998, Chan et al . 1999), and the gender/disability interface (Thierry 1988, Welner 1998, Iezzoni et al . 2000, Cheng et al .…”