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Brief report: cervical cancer screening in women with intellectual and developmental disabilities who have had a pregnancy
Author(s) -
Brown H. K.,
Plourde N.,
OuelletteKuntz H.,
Vigod S.,
Cobigo V.
Publication year - 2016
Publication title -
journal of intellectual disability research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.941
H-Index - 104
eISSN - 1365-2788
pISSN - 0964-2633
DOI - 10.1111/jir.12225
Subject(s) - medicine , pregnancy , odds ratio , confidence interval , demography , cervical cancer , population , residence , obstetrics , cohort , logistic regression , cohort study , gynecology , cancer , environmental health , sociology , genetics , biology
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. Method 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.