Barriers to breast cancer screening among women aged 40 years and older who have physical disabilities
Thierry, JoAnn M.
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Background Breast cancer is a public health concern for all women, including women with disabilities. These women are as likely as women without disabilities to have ever received a mammogram; however, they are significantly less likely to have been screened within the recommended guidelines. Although the public health community has increased breast cancer awareness and encouraged women to adopt preventive practices, few programs exist that target women with disabilities. Methods The Centers for Disease Control and Prevention conducted a qualitative study to explore the barriers to breast cancer screening and treatment for women with physical disabilities. Focus groups were conducted in seven regions across the United States. Participants were assigned to one of three groups: Group A, women with physical disabilities who had never received a mammogram or had not received one within the recommended guidelines (>2 years); Group B, women with physical disabilities who had received a mammogram within the recommended guidelines (d 2 years); and Group C, women with physical disabilities who had survived breast cancer. The primary research question was, “What are the barriers to breast cancer screening and treatment for women with physical disabilities?” Additional subquestions were asked to explore perceived risks for breast cancer, knowledge of mammography, interactions with the health care system, preventive behaviors, and environmental barriers to screening. Results Barriers fell into three categories: attitudinal, environmental, and system barriers. Frequently cited barriers included: perceived susceptibility, pre-occupation with other health issues, provider attitudes, inaccessible facilities and equipment, positioning, provider training, and health communication. Conclusions Improving screening rates requires a multifaceted approach at the federal, state, and local levels that improve environmental access, enhance provider training, increase outreach to women with disabilities, and improve health communication. Implications for Practice Women with disabilities must have equal access to health promotion, disease prevention, and medical services to optimize good health. Social workers play an important role in improving breast cancer screening services for women with disabilities. Better understanding of the barriers to cancer screening will lead to improved interventions directed at reducing morbidity and mortality among this population of women.