Women with disabilities have lower cervical cancer screening rates, study finds

Around 11,500 new cases of cervical cancer are diagnosed each year in the United States, according to the Centers for Disease Control (CDC). The CDC tracks cervical cancer rates by age, race, and ethnicity, but not by disability type. A 2022 study found that women with disabilities may encounter multiple social and economic barriers to accessing reproductive health care, and a lack of timely access to cervical cancer screening may lead to delayed diagnosis and treatment for cervical cancer.

According to research by Mason PhD in Public Health student Amarachukwu Orji, from 2018-2022, a lower proportion of women with disabilities, particularly those with physical and multiple disabilities, received cervical cancer screening via Human papillomavirus (HPV) testing, compared to women without disabilities.

The proportion of HPV testing was lower among women with any disability (50.2%) than among women without disabilities (54.8%). However, when broken out by type of disability, women with a cognitive disability had a higher screening rate (55.9%) and women with sensory (49.7%), physical (48.2%), and more than two disabilities (47.8%) disabilities had a lower screening rate than women without a disability.

Our research highlights differences in screening for cervical cancer by type of disability which suggest that there is a pressing need to understand the genesis of these disparities and identify ways to improve access to preventive health services by women with specific types of disability."

Amarachukwu Orji, principal investigator for the study

Orji looked at HPV screenings instead of Pap (Papanicolaou) tests, another method used to detect cervical cancer, because recent population-based randomized trials have found that HPV testing is more effective than Pap testing in detecting cervical cancer. HPV is the most common sexually transmitted infection in the United States and is a contributing factor for most cervical cancers.

Findings from this study revealed the rates of cervical cancer screening for all women using HPV tests (53.8%), Pap tests (81.1%), and co-testing (76.5%) within 5 years were below the national goals of 93% set by Healthy People 2020 and fell short of the new goal of 83.4% outlined in Healthy People 2030. Healthy People 2030 objectives are set by the U.S. Department of Health and Human Services that aim to increase the proportion of women receiving cervical cancer screening based on the latest guidelines to improve preventive care.

"Our research also places emphasis on the need for a concerted public health effort in raising awareness about these disparities in screening rates across women with disabilities and advocating for enhanced education for individuals, health care providers, and policymakers," said Orji.

The Association of Cervical Cancer Screening With Disability Type Among U.S. Women (Aged 25–64 Years) was published online in the American Journal of Preventative Medicine in August 2023. Tarang Parekh, Mason PhD in Health Services Research alumnus and assistant professor at the University of Delaware served as the senior supervisor of the study. Additional co-authors include Mason associate professor Gilbert Gimm and Aakash Desai from the Mayo Clinic.

This study was conducted in 2022 using pooled national data from the 2018 and the 2020 Behavioral Risk Factor and Surveillance System (BRFSS) for U.S. women aged 25-64 years old.