Breast and cervical cancer screening: Perceived barriers identified by low-income women with disabilities

Health disparities in cancer morbidity and mortality, as well as health service utilization, are important public health problems. The NCI indicates that lower rates of cancer screening and early detection are among factors contributing to advanced disease at diagnosis and higher cancer death rates among the underserved. Healthy People 2010 reports that women with disabilities lack access to health services and medical care. Access to primary care and health screening services may be very limited. Health screening services for female cancers, i.e. pelvic examinations and mammograms, may be particularly difficult to obtain. Women with disabilities may encounter attitudinal, environmental, economic and informational barriers to receiving health services. Women with disabilities have low rates of Pap tests, breast examinations and mammograms. Among low-income women, having a disability is likely to intensify problems with access to cancer screening. In a preliminary study designed to inform 2 funded projects, key informant qualitative interviews (6) were conducted with women with physical disabilities living in a large urban area. Questions, developed with input from content experts, included the following: access to primary health care; preventive health services, including breast and cervical cancer screening; satisfaction with care; experiences having the tests, e.g. transferring to the exam table, positioning. Recruitment was accomplished through a partnership with the Developmental Disabilities Institute. Themes identified by the preliminary interviews: women reporting access to cancer screening services also reported being in an ongoing system of health care and having an advocate/case manager to assist in navigating the health system.