BREAST AND CERVICAL-CANCER SCREENING AMONG WOMEN WITH PHYSICAL-DISABILITIES

Objective: This article reports findings from the National Study of Wo men with Physical Disabilities about rates of screening for breast and cervical cancer and factors associated with regular screening in a la rge sample of women with a variety of physical disabilities and a comp arison group of women without disabilities. Design: Case-comparison st udy using written survey. Data were analyzed using measures of central tendency, chi(2) analysis, logistic regression, and risk using odds r atios. Setting: General community. Participants: A total of 843 women, 450 with disabilities and 393 of their able-bodied friends, aged 18 t o 65, who completed the written questionnaire. The most common primary disability type was spinal cord injury (26%), followed by polio (18%) , neuromuscular disorders (12%), cerebral palsy (10%), multiple sclero sis (10%), and joint and connective tissue disorders (8%). Twenty-two percent had severe functional limitations, 52% had moderate disabiliti es, and 26% had mild disabilities. Main Outcome Measures: Outcomes wer e measured in terms of frequency of pelvic exams and mammograms. Resul ts: Women with disabilities tend to be less Likely than women without disabilities to receive pelvic exams on a regular basis, and women wit h more severe functional limitations are significantly less likely to do so. No significant difference was found between women with and with out disabilities, regardless of severity of functional limitation, in receiving mammograms within the past 2 years. Perceived control emerge d as a significant enhancement factor for mammograms and marginally fo r pelvic exams. Severity of disability was a significant risk factor f or noncompliance with recommended pelvic exams, but not mammograms. Ra ce was a significant risk factor for not receiving pelvic exams, but n ot mammograms. Household income and age did not reach significance as risk factors in either analysis. Conclusions: Women with physical disa bilities are at a higher risk for delayed diagnosis of breast and cerv ical cancer, primarily for reasons of environmental, attitudinal, and information barriers. Future research should focus on the subpopulatio ns that were not surveyed adequately in this study, women with disabil ities who have low levels of education or income, or who are of minori ty status. (C) 1997 by the American Congress of Rehabilitation Medicin e.