Utilisation of cancer screening services by disabled women in Chile

PLoS One. 2017 May 1;12(5):e0176270. doi: 10.1371/journal.pone.0176270. eCollection 2017.

Abstract

Background: Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile.

Methods: We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram).

Results: Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased.

Conclusions: This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and acknowledge the complexity of the patient population.

MeSH terms

  • Adult
  • Aged
  • Chile
  • Cross-Sectional Studies
  • Diagnostic Self Evaluation
  • Disabled Persons* / statistics & numerical data
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Insurance, Health / statistics & numerical data
  • Logistic Models
  • Mammography / statistics & numerical data*
  • Middle Aged
  • Odds Ratio
  • Papanicolaou Test / statistics & numerical data*
  • Socioeconomic Factors

Grants and funding

Elena S. Rotarou’s work was supported by the Conicyt-Fondecyt, Postdoctorate Programme under Project No. 3140481.