Examining Disparities in Cervical Cancer Screening with Pap Test by Types of Disability

Purpose: Prior research has found that poor receipt of cervical cancer screening is more prevalent among women with disabilities. However, there is a research gap regarding receipt of cervical cancer screening by types of disability. The purpose of this study was to examine the differences in the receipt of cervical cancer screening through self-reported Pap testing among women by types of disability. Methods: This cross-sectional study analyzed data from the 2016, 2018 and 2020 Behavioral Risk Factor and Surveillance System (BRFSS) to estimate the prevalence of Pap testing by disability type among women ages 21-65 years of age. Modified Poisson regression with robust error variance was conducted to examine difference in Pap testing among women by disability type. Disability was defined as having any difficulty with vision, hearing, cognitive, mobility, self-care, or independent living. Multivariate analyses adjusted for risk factors associated with cervical cancer screening. Results: A total of 307,142 women from across the U.S. were sampled. Women with multiple disabilities (aRR=0.91; 95% CI, 0.89 - 0.94) and women with ambulatory disability (aRR=0.94; 95% CI, 0.91 - 0.97) reported being less likely to receive Pap test than women with no disability. In every disability group, older women were significantly less likely to receive Pap test than their counterparts without disabilities. Conclusion: Ambulatory disability and multiple disabilities are associated with a lower likelihood of screening with Pap test, raising the increased need to eliminate disability-specific disparities in Pap testing.