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Women with developmental disabilities less likely screened for cervical and breast cancer

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Effective screening tests are available for both cervical and breast cancers and early detection leads to reductions in cancer incidence and mortality. However, the proportion of women with intellectual and developmental disabilities such as Down syndrome or autism who are screened for cervical cancer is around half that of women without such disabilities. In the case of mammography the proportion of screened women is about 1/3 lower, according to a new study by researchers at the Institute for Clinical Evaluative Sciences (ICES).

“The findings of our study suggest that women with intellectual and developmental disabilities face important health inequities in missed opportunities for the prevention and early detection of cervical and breast cancer,” says Yona Lunsky, director of the Healthcare Access Research and Developmental Disabilities (H-CARDD) research program, senior author of the study and adjunct scientist at ICES.

The study found:

  • About 34 per cent of women with intellectual and developmental disabilities (IDD) aged 20 to 69 received a Pap test over 3 years, compared with 66.8 per cent of women without IDD.
  • About 42 per cent of the women with IDD aged 50 to 69 received a mammogram over a 2-year period, compared with 60 per cent of women without IDD.
  • Differences observed between women with and without IDD remained when controlling for potential confounders.

 “Observed inequities reveal an urgent need for more intensive and group-specific or individually tailored strategies that can remove barriers to screening,” says Virginie Cobigo, lead author on the study.

The findings of this study are comparable to rates observed in other countries, such as the UK, USA and Australia. This is the first and largest study to examine screening rates in women with and without intellectual and developmental disabilities from the same population and using the same method.

There is a persistent belief that women with intellectual and developmental disabilities are not at risk of cervical and breast cancer. However, women with intellectual and developmental disabilities now live until the age of 71 years old on average, and thus are at risk for age-related diseases.

This study is part of the Healthcare Access Research in Developmental Disabilities (H-CARDD) Program.

Authors: V. Cobigo, H. Ouellette-Kuntz, R. Balogh, F. Leung, E. Lin, Y. Lunsky. 

The study “Are cervical and breast cancer screening programmes equitable? The case of women with intellectual and developmental disabilities” was published today in the Journal of Intellectual Disability Research.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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