Racial and ethnic disparities in cancer screening among working-age adults with disabilities

Background: Racial and ethnic disparities in receipt of healthcare are well-established in the general population. However, there has been little research investigating these disparities among people with disabilities. This study examined racial and ethnic disparities in cancer screening in working age adults (18-64 years) with disabilities.

Methods: Using Medical Expenditure Panel Survey (MEPS) data for 2002-2008, we conducted logistic regression analyses to examine associations between compliance with recommended cancer screening and race/ethnicity while controlling for demographic, economic, and health factors, as well as disability type and severity. The comparison group for all analyses was non-Hispanic Whites with disabilities. Analyses accounted for the complex survey design of MEPS.

Results: Asian/Native Hawaiian/Pacific Islanders (AHPI) had greater odds of not receiving any colorectal cancer screening (adjusted odds ratio [AOR] = 1.58, 95% CI 1.11-2.24). Non-Hispanic Black women (40+) had higher odds of going longer than recommended without a mammogram (AOR = 1.79, 95% CI 1.51-2.10). In contrast, Hispanic and Black women were less likely to be out of compliance with Pap test recommendations (Hispanics: AOR = 0.44, 95% CI 0.34-0.58; non-Hispanic Blacks: AOR = 0.42, 95% CI 0.34-0.51).

Conclusions: Racial and ethnic disparities in screening were observed even when controlling for other relevant factors. Although Hispanic and Black women were more likely to be current with Pap tests, other research suggests cervical cancer rates are still higher, and outcomes poorer, for these groups in the general population. Further research is needed to determine whether this is also true among women with disabilities.