Identifying factors associated with disability-related differences in breast cancer screening (United States).
OBJECTIVE
The purpose of this study was to identify factors that could explain breast cancer underutilization among women age 40 and older with disabilities.


METHODS
The data are part of the 1996 Medical Expenditure Panel Survey (MEPS), a nationally representative sample of medical care use and expenditures in the United States. Two different definitions of disability were used: limitations in activities of daily living (ADL) and limitations in instrumental activities of daily living (IADL). Annual mammography was used as the outcome measure. The data are restricted to noninstitutionalized women at least 40 years of age.


RESULTS
Crude odds ratios showed that women with long-term limitations in their ADLs or IADLs were less likely to be screened for breast cancer compared to those without such limitations. These associations remained while controlling for possible confounders and were observed among women age 40 or older, those 50-69, and among women 70 years of age and older.


CONCLUSIONS
Reasons for the underutilization of breast cancer screening among women with long-term disabilities remain elusive. Future studies need to examine additional factors in order to improve screening use, especially among women with long-term disabilities who are 50-69 years of age, for whom screening has been shown to be beneficial in terms of reduced risk of mortality from breast cancer.
Division of Health Behavior Research, Department of Pediatrics, Washington University School of Medicine, 4444 Forest Park Parkway, Box 8504, Saint Louis, MO 63108, USA. mschootm@im.wustl.edu
Mario
M
Schootman
Donna B
DB
Jeffe
D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D006233:Persons with Disabilities; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D012959:Socioeconomic Factors; D014481:United States