Table 1.
Systematic Review of Disparities among Women with Disabilities for Cancer Clinical Preventive Screenings
| Study, Year | Participants, n, Demographics, Disability |
Data Source: Primary Data (Further Description; Year[s]) |
Definition Clinical Preventive Screening |
Disability Severity Subgroups | Results | ||
|---|---|---|---|---|---|---|---|
| Cervical cancer screening (Pap smear) | |||||||
| Cheng, 2001 | MS patients; N = 692; Adults (M = 47); 86% White |
Received outpatient care in 3 U.S. health care systems |
Past 3 years | Mobility level | % | AOR | |
| Ambulatory | 93 | 5.32 | |||||
| Ambulatory with help | 79 | 2.11 | |||||
| Not ambulatory | 68 | REF | |||||
| Chevarley, 2006 |
N = 77,762 includes women without disability; Age ≥ 18; 76% White |
NHIS-D (1994–1995) | Functional limitations (n) | % in levels† | |||
| 0, 1–2, ≥3 | 0 | 1–2 | ≥3 | ||||
| Within past year | 49.6 | 47.9 | 45.1 | ||||
| 1–3 years | 24.9 | 24.6 | 26.6 | ||||
| >3 years | 16.2 | 22.0 | 19.0 | ||||
| Never | 5.7 | 2.7 | 4.1 | ||||
| Unknown | 3.7 | 2.8 | 5.3 | ||||
| Diab, 2004 |
N = 24,289*; Age ≥ 18; 78% White |
BRFSS 1998; 13 states | Past 3 years | Activity limitation | % | AOR | |
| No limitation | 83.8 | REF | |||||
| Mild disability | 78.8 | 0.98 | |||||
| Moderate disability (IADL) | 72.7 | 0.99 | |||||
| Severe disability (ADL) | 72.9 | 0.94 | |||||
|
N = 35,341*; Age ≥ 18; 68% White |
BRFSS 2000; 18 states | Activity limitation | % | AOR | |||
| None | 84.5 | REF | |||||
| Mild disability | 80.7 | 1.00 | |||||
| Moderate disability (IADL) | 77.5 | 0.99 | |||||
| Severe disability (ADL) | 81.9 | 1.07 | |||||
| Iezzoni, 2000 | N = 77,437; Age 18–75 | NHIS-D (1994–1995) | Past 3 years | Mobility problems | % | AOR | |
| Major: Unable to walk, climb stairs, stand, wheelchair/ scooter |
63.3 | 0.6 | |||||
| Moderate: A lot of difficulty | 79.6 | 1.3 | |||||
| Minor: Some difficulty | 79.4 | 1.2 | |||||
| None: No difficulty | 81.4 | REF | |||||
| Iezzoni, 2001 |
N = 77,762 total; includes women without disability; Age 18–75 |
NHIS-D (1994–1995) | Past 3 years | 1. Lower extremity mobility | % | AOR‡ | |
| Major/significant difficulty | 67.7 | 0.6 | |||||
| Some difficulty | 80.3 | 1.2 | |||||
| 2. Upper extremity mobility | % | AOR‡ | |||||
| Major/significant difficulty | 72.0 | 0.9 | |||||
| Some difficulty | 70.4 | 1.1 | |||||
| 3. Using hands | % | AOR‡ | |||||
| Major/significant difficulty | 72.5 | 0.9 | |||||
| Some difficulty | 70.8 | 0.7 | |||||
| Mammography | |||||||
| Cheng, 2001 | MS N = 245; Age ≥ 50; 86% White of total N |
Received outpatient care in 3 U.S. health care systems |
Past 2 years | Mobility level | % | AOR | |
| Ambulatory | 89 | 3.24 | |||||
| Ambulatory with help | 90 | 3.37 | |||||
| Not ambulatory | 71 | REF | |||||
| Chevarley, 2006 |
N = 77,762 total includes women without disability and younger ages; Age ≥ 30; 76% White in total N |
NHIS-D (1994–1995) | Functional limitations (n) | % in levels† | |||
| 0 | 1–2 | ≥3 | |||||
| Within the past | 0, 1–2, ≥3 | 29.6 | 32.3 | 28.2 | |||
| year | |||||||
| 1–2 years | 16.1 | 12.6 | 15.9 | ||||
| >2 years | 14.8 | 16.6 | 16.3 | ||||
| Never | 35.9 | 35.2 | 36.5 | ||||
| Unknown | 3.5 | 3.2 | 3.1 | ||||
| Diab, 2004 |
N = 10,356*; Age ≥ 50; 78% White of total sample N |
BRFSS 1998; 13 states | Past 2 years | Activity limitation | % | AOR | |
| None | 77.7 | REF | |||||
| Mild disability | 77.2 | 1.03 | |||||
| Moderate disability (IADL) | 71.6 | 0.99 | |||||
| Severe disability (ADL) | 68.4 | 0.84 | |||||
|
N = 14,522*; age ≥ 50; 68% White of total sample N |
BRFSS 2000; 18 states | Activity limitation | % | AOR | |||
| None | 82.2 | REF | |||||
| Mild disability | 80.0 | 1.00 | |||||
| Moderate disability (IADL) | 78.4 | 0.97 | |||||
| Severe disability (ADL) | 81.7 | 1.11 | |||||
| Iezzoni, 2000 |
N = 77,437 includes women without disability and younger ages; age ≥ 50 |
NHIS-D (1994–1995) | Past 2 years | Mobility problems | % | AOR | |
| Major: Unable to walk, climb stairs, stand, wheelchair/ scooter |
45.3 | 0.7 | |||||
| Moderate: A lot of difficulty | 51.5 | 0.9 | |||||
| Minor: Some difficulty | 58.3 | 1.0 | |||||
| None: No difficulty | 63.5 | REF | |||||
| Iezzoni, 2001 |
N = 77,762; includes women without disability and younger ages; age ≥ 50 |
NHIS-D (1994–1995) | Past 2 years | 1. Lower extremity mobility | % | AOR‡ | |
| Major/significant difficulty | 49.9 | 0.7 | |||||
| Some difficulty | 55.8 | 1.0 | |||||
| 2. Upper extremity mobility | % | AOR‡ | |||||
| Major/significant difficulty | 48.8 | 0.8 | |||||
| Some difficulty | 56.4 | 1.1 | |||||
| 3. Using hands | % | AOR‡ | |||||
| Major/significant difficulty | 41.7 | 0.6 | |||||
| Some difficulty | 52.6 | 0.8 | |||||
| Clinical breast examination | |||||||
| Cheng, 2001 | MS N = 245; age ≥ 50; 86% White of total N |
Received outpatient care in 3 U.S. health care systems |
Past year | Mobility level | % | AOR | |
| Ambulatory | 86 | 3.62 | |||||
| Ambulatory with help | 79 | 1.83 | |||||
| Not ambulatory | 69 | REF | |||||
| Chevarley, 2006 |
N = 77,762 total includes women without disability and younger ages; age ≥ 30; 76% White in total N |
NHIS-D (1994–1995) | Functional limitations (n) | % in levels† | |||
| 0 | 1–2 | ≥3 | |||||
| Within the past | 0, 1–2, >3 | 53.7 | 51.7 | 54.4 | |||
| year | |||||||
| 1–2 years | 18.7 | 17.9 | 16.4 | ||||
| >2 years | 18.5 | 20.3 | 20.3 | ||||
| Never | 5.0 | 7.4 | 5.1 | ||||
| Unknown | 4.1 | 2.7 | 3.8 | ||||
| Diab, 2004 |
N = 10,466*; age ≥ 50; 78% White in total sample N |
BRFSS 1998; 13 states | Past year | Activity limitation | % | AOR | |
| None | 67.4 | REF | |||||
| Mild disability | 64.2 | 0.98 | |||||
| Moderate disability (IADL) | 60.6 | 0.96 | |||||
| Severe disability (ADL) | 59.3 | 0.96 | |||||
|
N = 14,636*; age ≥ 50; 68% White in total sample N |
BRFSS 2000; 18 states | Activity limitation | % | AOR | |||
| None | 67.9 | REF | |||||
| Mild disability | 63.0 | 0.93 | |||||
| Moderate disability (IADL) | 63.6 | 0.96 | |||||
| Severe disability (ADL) | 60.1 | 1.05 | |||||
| Iezzoni, 2000 |
N = 77,437; includes women without disability and younger ages; age ≥ 50 |
NHIS-D (1994–1995) | Past 2 years | Mobility problems | % (no AOR) | ||
| Major: Unable to walk, climb stairs, stand, wheelchair/ scooter |
63.9 | ||||||
| Moderate: A lot of difficulty | 65.4 | ||||||
| Minor: Some difficulty | 71.7 | ||||||
| None: No difficulty | 75.7 | ||||||
| Iezzoni, 2001 |
N = 77,762; includes women without disability and younger ages; age ≥ 50 |
NHIS-D (1994–1995) | Past 2 years | 1. Lower extremity mobility | % | AOR‡ | |
| Major/significant difficulty | 67.4 | 0.6 | |||||
| Some difficulty | 69.2 | 1.2 | |||||
| 2. Upper extremity mobility | % | AOR‡ | |||||
| Major/significant difficulty | 69.3 | 0.9 | |||||
| Some difficulty | 67.0 | 1.1 | |||||
| 3. Using hands | % | AOR‡ | |||||
| Major/significant difficulty | 69.3 | 0.9 | |||||
| Some difficulty | 64.8 | 0.7 | |||||
Abbreviations: ADL, activities of daily living; AOR, adjusted odds ratio; BRFSS, Behavioral Risk Factor Surveillance System; CI, confidence interval; FL, functional limitation; IADL, Instrumental ADL; M, mean; MS, multiple sclerosis; NHIS-D, National Health Interview Survey-Disability supplement; REF, referent group; RR, relative risk.
*
Sample n’s for this study are for the prevalence figures. Adjusted models had fewer subjects.
†
Prevalence figures for this study are age adjusted.
‡
Reference group for comparisons in this study are all women without the specific disability in that cell.