The Association of Cervical Cancer Screening With Disability Type Among U.S. Women (Aged 25-64 Years)

Am J Prev Med. 2024 Jan;66(1):83-93. doi: 10.1016/j.amepre.2023.08.010. Epub 2023 Aug 13.


Introduction: Despite a gradual decline in cervical cancer mortality because of greater use of screening, including Pap and human papillomavirus (HPV) tests, disparities in screening among adult women by disability type have not been examined. This study aims to assess the odds of cervical cancer screening using HPV tests by disability type among U.S. women aged 25-64 years.

Methods: This study was analyzed in 2022 using pooled data from 2018 and the 2020 Behavioral Risk Factor and Surveillance System. The analytic sample included 189,795 women aged 25-64 years. Disability was defined as having any sensory disability, cognitive disability, physical disability, ≥2 disabilities, or no disability adapted from a standardized questionnaire. Descriptive analyses were used to estimate the proportion of HPV tests on the basis of 2020 American Cancer Society guidelines, which recommend testing within five years for all women aged 25-65 years. Multivariable analyses were conducted to estimate AORs of cervical cancer screening by disability type.

Results: Overall, 53.8% of women met recommended 2020 American Cancer Society guidelines for cervical cancer screening using HPV tests. The proportion of HPV tests was higher in women with a cognitive disability (55.9%) and lower in those with sensory (49.7%), physical (48.2%), and ≥2 disabilities (47.8%) than in those without disabilities (54.8%). In adjusted analyses, women with any disability (AOR=0.95, 95% CI=0.88, 0.97), physical disability (AOR=0.96, 95% CI=0.80, 0.98), and ≥2 disabilities (AOR=0.88, 95% CI=0.78, 0.97) had lower odds of receiving cervical cancer screening with HPV testing than women without disabilities.

Conclusions: Disparities in screening with HPV tests among women with physical and ≥2 disabilities suggest the need for a targeted approach to improve prevention screening awareness, access, and availability in this population.

MeSH terms

  • Adult
  • Early Detection of Cancer
  • Female
  • Humans
  • Mass Screening
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / epidemiology
  • Papillomavirus Infections* / prevention & control
  • Patient Acceptance of Health Care
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / prevention & control
  • Vaginal Smears