title: Brief report: cervical cancer screening in women with intellectual and developmental disabilities who have had a pregnancy.
abstract: BACKGROUND
  Women with intellectual and developmental disabilities (IDD) have lower cervical cancer screening rates than women without IDD. Key barriers to screening uptake include physician or caregiver assumptions that screening is unnecessary because women with IDD are not sexually active. Our objective was to compare cervical cancer screening rates in women with and without IDD who had had a pregnancy.
  
  
  METHODS
  We conducted a population-based retrospective cohort study using linked Ontario (Canada) health and social services administrative data. We identified 20- to 64-year-old women with (N = 5033) and without (N = 527 437) IDD who had had a pregnancy. We examined the occurrence of cervical cancer screening between April 1, 2007 and March 31, 2010. We compared screening rates in women with and without IDD using logistic regression, controlling for age, region of residence, neighbourhood income quintile and morbidity level.
  
  
  RESULTS
  Women with IDD who had had a pregnancy were more likely than those without IDD to be young, to live in the lowest neighbourhood income quintile, to live in rural areas and to have high or very high morbidity. Even after controlling for these factors, women with IDD were less likely than women without IDD to be screened (67.7% vs. 77.0%; adjusted odds ratio 0.61; 95% confidence interval 0.58-0.65).
  
  
  CONCLUSIONS
  Even among women who have had a pregnancy and are therefore known to have been sexually active, women with IDD face significant disparities in cervical cancer screening. Strategies to promote equitable uptake of cervical cancer screening for women with IDD need to be implemented.
authors.affiliation: Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: H K
authors.initials: HK
authors.lastname: Brown
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Plourde
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: H
authors.initials: H
authors.lastname: Ouellette-Kuntz
authors.affiliation: Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Vigod
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Cobigo
mesh_terms: D000328:Adult; D002658:Developmental Disabilities / Q000453:epidemiology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
keywords: administrative data; healthcare disparities; intellectual and developmental disabilities; population-based study