Problems for Women With Disabilities Receiving Breast Cancer Preventative Practices
By Myra Salgado
Breast cancer has become the most diagnosed cancer in women in recent years, and, aside from the obvious health problems, there still seem to be external challenges women with breast cancer face, but invasive medical treatments are one of the most common ones. Such exams, like mammography screenings, can create discomfort and fear among women, which could lead to a refusal of such a practice. Concerningly, medical literature has shown that women with disabilities have worse screening rates of cancer-preventative practices when compared to women with no disabilities (Stolze and Fox, 2011). What could cause such an alarming pattern?
The first glaring obstacle women with disabilities face is the shortcomings of the medical field. Various medical studies have found a disparity between mortality risk (Inchai et al., 2024; McCarthy, 2006). Women with disabilities had a higher mortality risk of breast cancer because they are less likely to undergo preventative screenings at an early stage, leading to decreased survival rates, worsened prognosis, and deteriorated treatment outcomes (Reichard et al., 2011; Almohammed, 2024). Interestingly, The National Health Interview Survey Data of 2010 revealed that 75% of women without disabilities received a mammogram during the previous two years, while only 61% of women with disabilities received a mammogram. Mammograms are one of the most avoided preventative practices, due to their invasiveness and various obstacles. In fact, people with disabilities have worse screening rates than the “no disability” groups, yet rates at which each group received preventative cancer screenings were far below the accepted standards suggested by the U.S. Preventative Task Force.
Even though the medical field has improved its attitude towards the disabled, there is a clear way to provide appropriate care to women with disabilities. Thankfully, there is steady progress in making cancer preventative practices more accessible than before. Traci and coworkers (2020) found that hospitals are steadily improving the accessibility of mammography centers and mammography rooms. It is that such an endeavor has started, yet, unfortunately, it will be a long time before hospitals around the world, including rural areas, have such luxuries.
“Kilic and colleagues (2019) found in a study that women with disabilities expressed anxiety about health screenings, such as mammography, due to a feeling of having low medical literacy and fearing the inadequate knowledge of their healthcare professionals about their disabilities.”
There are far fewer resources women with disabilities have available compared to other groups. People with disabilities are more likely to encounter several barriers while accessing worthy healthcare resources. With good healthcare, women with disabilities could access opportunities for excellent treatments and services to achieve optimal health (Baylor College of Medicine, n.d.). According to the National Disability Institute, the poverty rate for adults with disabilities is more than twice the rate of adults with no disability. Therefore, women with disabilities with SSI or low-income face financial barriers to accessing even routine health care, such as mammography screenings, heightening their risk for late-stage cancer and increasing mortality rates (McCarthy, 2006). Access to preventative screenings is largely influenced by financial factors, but sociocultural and structural problems can also negatively affect women with disabilities. Matin et al. (2021) found that women with disabilities face a lack of knowledge, lack of information, and communication problems that could impact their access to quality healthcare.
Communicative problems can also negatively impact women with disabilities perspective on mammography. With low communication, medical literacy would not expand, further creating a rift between health screenings and women with disabilities. Kilic and colleagues (2019) found in a study that women with disabilities expressed anxiety about health screenings, such as mammography, due to a feeling of having low medical literacy and fearing the inadequate knowledge of their healthcare professionals about their disabilities. Unfortunately, there are discriminatory attitudes toward women with disabilities held by service providers, usually stemming from limited understanding of disabilities, lack of confidence in providing services for women with disabilities, or refusal to accommodate treatments towards women with disabilities (Lee, 2015). These gaps could be fixed through open communication between medical staff and patients.
Comfort in mammography screenings could be increased if women with disabilities knew about their sexual health and reproductive rights and knew what to expect from such an invasive practice. Further comfort could be provided if medical professionals informed themselves and took the initiative to bridge the gap of miscommunication. Better communication can be achieved if information on sexual reproductive health and preventable screenings are made to focus on simple and readily understandable key messages delivered in various formats to fit the diversity of disabled groups (Gartrell et al., 2017). Another way to possibly increase the screening rates for women with disabilities is to have cancer awareness-raising campaigns include empowering stories of women with disabilities as valued and full members of society worthy of respect.
References
Almohammed, H. I. (2024). A systematic review to evaluate the barriers to breast cancer screening in women with disability. Journal of Clinical Medicine, 13(11), 3283. https://doi.org/10.3390/jcm13113283
Baylor College of Medicine (n.d.). Access to healthcare for women with disabilities. https://www.bcm.edu/center-for-research-on-women-with-disabilities/access-to-healthcare
Gartrell, A., Baesel, K., & Becker, C. (2017). “We do not dare to love”: Women with disabilities’ sexual and reproductive health and rights in rural Cambodia. Reproductive Health matters, 25(50), 31-42. https://doi.org/10.1080/09688080.2017.1332447
Goodman, N., Morris, M., & Boston, K. (2017). Financial inequality: Disability, race, and poverty in America. National Disability Institute. https://www.nationaldisabilityinstitute.org/disability-race-poverty-in-america.pdf
Inchai, P., Tsai, W. T., Chiu, L., & Kung, P. (2024). Cancer stages and mortality risk of breast cancer between women with and without disabilities: A national population-based cohort study in Taiwan. Disability and Health Journal, 17(3), 101632. https://doi.org/10.1016/j.dhjo.2024.101632
Kilic, A., Tastan, S., Guvenc, G., & Akyuz, A. (2019). Breast and cervical cancer screening for women with physical disabilities: A quantitative study of experiences and barriers. Journal of Advanced Nursing, 75(9), 1976-1986. https://doi.org/10.1111/jan.14048
Lee, K., Devine, A., Marco, M. J., Zayas, J., Gill-Atkinson, L., & Vaughan, C. (2015). Sexual and reproductive health services for women with disability: A qualitative study with service providers in the Philippines. BMC Women’s Health, 15(87). https://doi.org/10.1186/s12905-015-0244-8
Matin, B. K., Williamson, H. J., Karyani, A. K., Rezaei, S., Soofi, M., & Soltani, S. (2021). Barriers in access to healthcare for women with disabilities: A systematic review in qualitative studies. BMC Women’s Health, 21(44). https://doi.org/10.1186/s12905-021-01189-5
McCarthy, E. P., Ngo, L. H., Roetzheim, R. G., Chirikos, T. N., Li, D., Drews, R. E., & Iezzoni, L. (2006). Disparities in breast cancer treatment and survival for women with disabilities. Annals of Internal Medicine, 145(9). https://doi.org/10.7326/0003-4819-145-9-200611070-00005
Reichard, A., Stolzle, H., & Fox, M. (2011) Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States. Disability and Health Journal, 4(2), 59-67. https://doi.org/10.1016/j.dhjo.2010.05.003
Traci, M. A., Horan, H., Russette, H., Goe, R., Ware, R., Powell, K., Hughes, R. B., & Hicks, E. (2020). Improving mammography access for women with disabilities: Outcomes of the CDC’s right to know campaign. Frontiers in women’s health, 5(3), 10. https://doi.org/10.15761/fwh.1000188
Resources
https://centers.rowanmedicine.com/risn/documents/102220risnblogfinal_breastca_jcedits.pdf
https://www.aahd.us/wp-content/uploads/2012/03/MammoTipsWomen2009.pdf
About the Author
Myra Salgado is an intern with HELEN.