"I Want to Help, but What Do You Do in a Situation Like That?" Health Care Providers' Qualitative Perspectives on Working with Disabled Women in Breast Cancer Screening

Defining breast cancer awareness and identifying barriers to breast cancer awareness for women with an intellectual disability: A review of the literature

INTRODUCTION

Incidence rates for developing breast cancer are similar for women regardless of intellectual ability. However, women with an intellectual disability present with advanced breast cancers, which often have a poor prognosis.

METHOD

A structured narrative review of the literature was performed to explore the concepts of breast awareness and breast cancer awareness and subsequently, identify barriers to breast cancer awareness encountered by women with an intellectual disability.

RESULTS

A total of 22 studies involving people with varying levels of intellectual disability informed this review. The barriers to breast cancer awareness encountered by women with an intellectual disability include: lack of their understanding, the role of the carer and literacy issues.

CONCLUSION

Identifying the barriers to breast cancer awareness for women with an intellectual disability will help to facilitate breast cancer awareness which has the potential to result in better long-term outcomes through an early diagnosis of breast cancer.

Uptake of cancer screening among adults with disabilities in Flanders (Belgium)

Objective

To explore the association between disability and participation in breast, cervical, and colorectal cancer screening in Flanders (Belgium).

Methods

Data from the Centre for Cancer Detection were linked to data of the Flemish Agency for disabled persons by the Crossroads Bank for Social Security, using National Social Security Numbers.

Results

The study population consisted of 92,334 invited individuals registered as disabled in 2013–2015. For breast cancer screening (including both opportunistic screening and participation in the screening program), 51.7% of disabled women had undergone mammography in the last two years, compared with the Flemish uptake of 61.8%. In cervical screening, 45% of the women with a disability had undergone a PAP smear in the last three years (overall Flemish uptake was 60.7%). For colorectal cancer screening, 40.7% of individuals with a disability had undergone a fecal immunochemical test in the last two years (overall Flemish uptake was 51.5%). Participation in breast and colorectal cancer screening among persons with a disability was 10% points less than the Flemish average during the same period. In the cervical cancer screening program, the difference between the participation of disabled women and the Flemish average was 10% points. Persons with any type of disability had a lower uptake of cancer screening than the Flemish average, except for individuals with a hearing impairment.

Conclusions

Participation disparities in the Flemish cancer screening programs between persons with and without disabilities require specific efforts to increase cancer screening among people with a disability.