Breast cancer screening disparities between women with and without disabilities: A national database study in South Korea
- Authors
- Shin, Dong Wook; Yu, Jonghan; Cho, Juhee; Lee, Se Kyung; Jung, Jin Hyung; Han, Kyungdo; Kim, So Young; Yoo, Jung Eun; Yeob, Kyoung Eun; Kim, Yeon Yong; Park, Jong Heon; Park, Jong Hyock; Kawachi, Ichiro
- Issue Date
- Apr-2020
- Publisher
- WILEY
- Keywords
- breast cancer; disabled; disparity; Korea; mammography; screening
- Citation
- CANCER, v.126, no.7, pp.1522 - 1529
- Journal Title
- CANCER
- Volume
- 126
- Number
- 7
- Start Page
- 1522
- End Page
- 1529
- URI
- http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/38729
- DOI
- 10.1002/cncr.32693
- ISSN
- 0008-543X
- 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.
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