Breast cancer screening (mammogram)

Cancer Screening in Women

In 2013, H-CARDD researchers published the article "Are cervical and breast cancer screening programmes equitable? The case of women with intellectual and developmental disabilities", in the Journal of Intellectual Disability Research.

Download the full article here.

We interviewed Dr. Liisa Jaakkimainen, family physician and health services researcher, and asked her to comment on the article. This is what she thought about the research findings.

Brief outline of the article

Cancer screening programs are available in Canada for all eligible women. This study investigates screening rates for cervical and breast cancer in women with developmental disabilities compared to women in the general population. The results show that the proportion of women with developmental disabilities who are not screened for cervical cancer is nearly twice what it is in women without developmental disabilities, and 1.5 times for breast cancer screening.

What did you find important in this article?

From a clinical perspective the results of this study show that we are not screening women with intellectual disabilities as well as we might for breast and cervical cancer.  It does not surprise me that women with developmental disabilities who have multiple health problems receive less screening because clinicians focus less on preventative health care and screening when they see patients with complex health issues. What does come as a surprise from a research perspective is that healthy women with developmental disabilities are less likely to receive cancer screening than healthy women without developmental disabilities.

How will you use the information from this study in your work?

As a family doctor, the research makes me more aware of the importance of presenting the available screening options to women with developmental disabilities and of preventative health care for this population in general. As a researcher, when studying primary health care performance, I usually take socio-economic status and the presence of multiple health issues into consideration. Perhaps I should take developmental disabilities into account as well.

Do you foresee any challenges using this information in your work?

Finding the right strategy to increase the uptake of cancer screening in women with developmental disabilities will be a challenge. I believe physicians will need to collaborate with health care providers from other disciplines to better reach this specific group of patients.  For example, I work closely with a nurse who does most of the Pap tests for cervical cancer in my practice. Improvements may involve changes in clinical programs or in the approaches we use for women with developmental disabilities, such as, implementing alerts for breast cancer screening.

How do the findings of this study relate to what you already knew or thought?

The results of this study are a reminder to physicians that this subgroup of patients is being under-served. The large data base from which the findings are drawn and the population health perspective add to the credibility of the numbers. Although I expected some differences in screening uptake, looking at the results of this study, I was surprised by the degree of inequality in access to cancer screening.

Do you have any questions or comments to the authors of this article?

What strategies would you recommend to increase the uptake of preventative cancer screening in women with developmental disabilities?