title: Reach of the Montana Cancer Control Program to Women with Disabilities.
abstract: Women with disabilities have lower screening rates for breast and cervical cancer with some evidence suggesting that people with disabilities experience higher cancer mortality and may receive a different course of treatment. This study examined whether women with and without disabilities using Montana Cancer Control Program (MCCP) differ in use of breast (BCS) and cervical (CCS) screening services, receipt of and follow up for inconclusive or abnormal results, and compliance with BCS and CCS US Preventive Services Task Force recommendations. Study participants were women eligible for MCCP screening services between November 2012 and October 2014, with eligibility based on insurance status (underinsured/no insurance), income requirements (<200 % poverty based on income/household size), and age. The data derive from participant self-report (demographic, disability, and health history including previous mammogram or Papanicolaou test) and MCCP records of screening tests (clinical breast exam, mammogram, or Pap test), results, and follow up visits. About 11.5 % of MCCP participants reported having a disability. MCCP recipients with a disability were significantly older, more likely to be non-Hispanic White, and more likely to have poor health profiles. Disability status did not affect use of MCCP screening services, screening outcome, or follow up for inconclusive or abnormal results. However, women with disability had significantly lower BCS and CCS compliance (based on US Preventive Task Force guidelines) than women without disability, which persisted in adjusted analyses controlling for other significant factors. The MCCP is reaching un/underinsured Montana women with disabilities. While disability status in this sample was not related to use of MCCP services or screening outcome, MCCP recipients with disabilities have significantly lower BCS and CCS compliance. Efforts to increase compliance for un/underinsured Montana women with a disability are warranted.
authors.affiliation: Dallas Regional Campus, Health Promotion/Behavioral Sciences Department, University of Texas School of Public Health, Dallas, TX, USA. kfgrobe@yahoo.com.
authors.forename: Katherine
authors.initials: K
authors.lastname: Froehlich-Grobe
authors.affiliation: Dallas Regional Campus, Epidemiology, Human Genetics, and Environmental Sciences Department, University of Texas School of Public Health, Dallas, TX, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Shropshire
authors.affiliation: Chronic Disease Prevention and Health Promotion Bureau, Public Health and Safety Division, Montana Department of Public Health and Human Services, Helena, MT, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Zimmerman
authors.affiliation: Chronic Disease Prevention and Health Promotion Bureau, Public Health and Safety Division, Montana Department of Public Health and Human Services, Helena, MT, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Van Brunt
authors.affiliation: Dallas Regional Campus, Health Promotion/Behavioral Sciences Department, University of Texas School of Public Health, Dallas, TX, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Betts
mesh_terms: D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D009009:Montana; D011203:Poverty; D057566:Self Report; D055815:Young Adult
keywords: Cancer screening; Health disparity; Women with disability