Breast cancer screening disparities between women with and without disabilities: A national database study in South Korea

Background Health disparities among individuals with disabilities remain underrecognized. The objective of the current study was to investigate: 1) whether disparities exist in breast cancer screening rates among women with disabilities compared with women without disabilities; 2) whether breast cancer screening rates vary according to the type and severity of disabilities; and 3) trends in breast cancer screening disparities according to disability status over time. Methods Using national administrative databases concerning disability status and national cancer screening programs in Korea, age‐standardized participation rates were calculated according to the type and severity of disabilities. Results The age‐standardized rate for breast cancer screening in individuals with disabilities increased from 30.2% in 2006 to 53.7% in 2015 (change of +23.5%), whereas that among those without a disability increased from 29.3% to 60.1% (change of +30.8%). In general, disability was associated with slightly lower breast cancer screening rates (adjusted odds ratio [aOR], 0.824; 95% CI, 0.820‐0.828). However, screening rates were especially low in women with severe disabilities (aOR, 0.465; 95% CI, 0.461‐0.469) and among women with autism (aOR, 0.235; 95% CI, 0.143‐0.388), renal failure (aOR, 0.342; 95% CI, 0.337‐0.348), brain injury (aOR, 0.349; 95% CI, 0.346‐0.352), intellectual disabilities (aOR, 0.403; 95% CI, 0.397‐0.410), mental disorders (aOR, 0.494; 95% CI, 0.488‐0.501), or ostomies (aOR, 0.529; 95% CI, 0.512‐0.546). Conclusions Even without a cost barrier, significant disparities were found in breast cancer screening participation, especially in women with severe disabilities and brain‐related and/or mental disabilities. Policy efforts, such as ensuring the accessibility of information and equipment, transportation support, and access to a usual source of care, should be made to decrease this disparity. The results of the current study demonstrate significant disparities in participation in breast cancer screening, especially among women with severe disabilities and brain‐related and/or mental disabilities. Although breast cancer screening rates in women with disabilities are found to increase over time, the gap widens when these individuals are compared with women without disabilities.