Women With Severe Disabilities and Chronic Health Issues Screened Less Often for Breast Cancer

Women with severe disabilities and chronic health issues are seldom screened for breast cancer, a new study reveals.

The study, led by St. Michael's Hospital along with the Institute for Clinical Evaluative Ministry of Health, found that when compared to women with no disabilities of any chronic condition, women with severe disabilities or multiple chronic conditions are screened less often for breast cancer, one of the most common types of cancer among women in the U.S. It is estimated that about 1 in every 8 women in the U.S. develop invasive breast cancer.

According to Dr. Sara Guilcher, an affiliate scientist with the Li Ka Shing Knowledge Institute of St. Michael's Hospital, women with severe, chronic health issue are screened even less often that those with moderate disabilities or women with a single chronic condition. The researcher insists that women with severe disabilities often have several other measures of social vulnerability like low income and low education levels.

This study supports previous findings that claim low income and poor education have a strong association with lower breast cancer screening rates. Earlier studies have also revealed that those with particular level of disability have higher breast screening rates, mostly because they are in regular contact with the healthcare system.

In contrast to earlier finding, this study found greater screening rates for women with moderate disability when compared to those with severe disabilities who have frequent contact with physicians.

"Despite the presence of a universal health insurance system in Ontario, our research highlights the persistence of significant health disparities in breast cancer screening, particularly for women who are more vulnerable due to severe disability, multiple chronic conditions, low income and lower education," said Dr. Guilcher, who has a PhD in Clinical Epidemiology at the Institute of Health Policy, Management and Evaluation, University of Toronto.

Women with moderate level of disability and one chronic condition had higher rate of screening - 75 percent. The lowest rate of breast cancer screening i.e. 61 percent was among those with severe disability across levels of chronic condition. Those with two or more chronic condition were screened less often.

"Women who are at a lower socioeconomic position may be less likely to be assertive and to be strong advocates for their health care management," said Dr. Guilcher.

 The study was documented in journal Preventive Medicine.