Original article| Volume 25, ISSUE 3, P246-253, May 2015

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Disparities in Receipt of Breast and Cervical Cancer Screening for Rural Women Age 18 to 64 with Disabilities

Published:April 09, 2015DOI:



      Previous research has found breast and cervical cancer screening disparities between women with and without disabilities, and between women living in rural versus urban areas. Living in a rural area may add to the barriers women with disabilities experience when attempting to obtain screening for breast and cervical cancer. The purpose of this study was to examine the combination of disability status and rurality in association with receipt of breast and cervical cancer screening among women age 18 to 64 in the United States.


      We conducted cross-sectional analyses of data from the Medical Expenditure Panel Survey, using pooled annual data files from 2002 through 2008. We compared recent receipt of breast and cervical cancer screening among four groups: 1) urban women without disabilities, 2) urban women with disabilities, 3) rural women without disabilities, and 4) rural women with disabilities.


      Overall, women with disabilities were less likely to be up to date with mammograms and Pap tests compared with women with no disabilities. Similarly, women in rural areas were less likely to have received breast or cervical cancer screening within recommended timeframes. Women who both had a disability and lived in a rural area were the least likely to be current with screening.


      Our findings suggest that living in rural regions compounds disparities in receipt of cancer screening among women with disabilities. Increased attention is needed to improve receipt of cancer screening among rural women with disabilities.
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      Willi Horner-Johnson, PhD, is an Associate Professor of Public Health and Preventive Medicine at Oregon Health & Science University in Portland, Oregon. Her research is based in OHSU's Institute on Development & Disability.


      Konrad Dobbertin, MPH, was a Research Assistant in the Institute on Disability and Development at Oregon Health & Science University when the bulk of this work was performed. He is now a consultant for West Coast Informatics.


      Lisa I. Iezzoni, MD, MSc, is Professor of Medicine at Harvard Medical School and Director of the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston. Dr. Iezzoni is a member of the Institute of Medicine, National Academy of Sciences.