Prevalence of breast, cervical, and colorectal cancer screening among adults according to disability type and difficulty level, United States, 2021 and 2023

Background

Adults with disabilities face multiple barriers to cancer screening services. Few studies have examined screening receipt across multiple disability domains via standardized measures in contemporary nationally representative samples.

Methods

Data were pooled from the 2021 and 2023 National Health Interview Survey. Prevalence of United States Preventive Services Task Force recommendation concordant breast, cervical, and colorectal cancer screening was estimated according to disability domain (vision, hearing, mobility, cognition, communication, and self-care) and difficulty level (“substantial,” “some,” and “none”), which were defined according to the Washington Group Composite Disability Indicator.

Results

A total of 1712, 1147, and 3106 sample respondents eligible for breast, cervical, and colorectal screening had disabilities, respectively, which translates to 6.02 million, 5.10 million, and 11.17 million when population weighted. Breast and cervical screening prevalence decreased with increasing difficulty level for self-care, vision, mobility, and cognition domains, with the lowest receipt among those reporting substantial versus no self-care difficulties (breast: 52% vs. 79%; adjusted prevalence ratio [aPR], 0.69; 95% CI, 0.58–0.82; cervical: 37% vs. 78%; aPR, 0.63; 95% CI, 0.51–0.78). Communication disability was associated with lower cervical screening (35% substantial vs. 78% none; aPR, 0.65; 95% CI, 0.52–0.82) but not for other screenings. Conversely, stool testing for colorectal screening was higher among adults with substantial mobility difficulties (22% vs. 16% none; aPR, 1.24; 95% CI, 1.12–1.38) and some self-care, mobility, and vision difficulties, compared to those with none.

Conclusions

Addressing barriers for individuals with self-care limitations could improve suboptimal screening levels across multiple cancer screenings. Self-sampling modalities, including stool testing, may mitigate accessibility issues, and warrant further evaluation.