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. 2020 Apr 1;126(7):1522-1529.
doi: 10.1002/cncr.32693. Epub 2020 Jan 6.

Breast cancer screening disparities between women with and without disabilities: A national database study in South Korea

Dong Wook Shin  1   2 , Jonghan Yu  3 , Juhee Cho  2   4   5   6 , Se Kyung Lee  3 , Jin Hyung Jung  7 , Kyungdo Han  7 , So Young Kim  8   9   10 , Jung Eun Yoo  1 , Kyoung Eun Yeob  8 , Yeon Yong Kim  11 , Jong Heon Park  11 , Jong Hyock Park  8   10 , Ichiro Kawachi  10
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Free article

Breast cancer screening disparities between women with and without disabilities: A national database study in South Korea

Dong Wook Shin et al. Cancer. .
Free article

Abstract

Background: Health disparities among individuals with disabilities remain underrecognized. The objective of the current study was to investigate: 1) whether disparities exist in breast cancer screening rates among women with disabilities compared with women without disabilities; 2) whether breast cancer screening rates vary according to the type and severity of disabilities; and 3) trends in breast cancer screening disparities according to disability status over time.

Methods: Using national administrative databases concerning disability status and national cancer screening programs in Korea, age-standardized participation rates were calculated according to the type and severity of disabilities.

Results: The age-standardized rate for breast cancer screening in individuals with disabilities increased from 30.2% in 2006 to 53.7% in 2015 (change of +23.5%), whereas that among those without a disability increased from 29.3% to 60.1% (change of +30.8%). In general, disability was associated with slightly lower breast cancer screening rates (adjusted odds ratio [aOR], 0.824; 95% CI, 0.820-0.828). However, screening rates were especially low in women with severe disabilities (aOR, 0.465; 95% CI, 0.461-0.469) and among women with autism (aOR, 0.235; 95% CI, 0.143-0.388), renal failure (aOR, 0.342; 95% CI, 0.337-0.348), brain injury (aOR, 0.349; 95% CI, 0.346-0.352), intellectual disabilities (aOR, 0.403; 95% CI, 0.397-0.410), mental disorders (aOR, 0.494; 95% CI, 0.488-0.501), or ostomies (aOR, 0.529; 95% CI, 0.512-0.546).

Conclusions: Even without a cost barrier, significant disparities were found in breast cancer screening participation, especially in women with severe disabilities and brain-related and/or mental disabilities. Policy efforts, such as ensuring the accessibility of information and equipment, transportation support, and access to a usual source of care, should be made to decrease this disparity.

Keywords: Korea; breast cancer; disabled; disparity; mammography; screening.

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References

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