BACKGROUND Health disparities among individuals with disabilities remain underrecognized. The objective of the current study was to investigate: 1) whether disparities exist in breast cancer screening rates among women with disabilities compared with women without disabilities; 2) whether breast cancer screening rates vary according to the type and severity of disabilities; and 3) trends in breast cancer screening disparities according to disability status over time. METHODS Using national administrative databases concerning disability status and national cancer screening programs in Korea, age-standardized participation rates were calculated according to the type and severity of disabilities. RESULTS The age-standardized rate for breast cancer screening in individuals with disabilities increased from 30.2% in 2006 to 53.7% in 2015 (change of +23.5%), whereas that among those without a disability increased from 29.3% to 60.1% (change of +30.8%). In general, disability was associated with slightly lower breast cancer screening rates (adjusted odds ratio [aOR], 0.824; 95% CI, 0.820-0.828). However, screening rates were especially low in women with severe disabilities (aOR, 0.465; 95% CI, 0.461-0.469) and among women with autism (aOR, 0.235; 95% CI, 0.143-0.388), renal failure (aOR, 0.342; 95% CI, 0.337-0.348), brain injury (aOR, 0.349; 95% CI, 0.346-0.352), intellectual disabilities (aOR, 0.403; 95% CI, 0.397-0.410), mental disorders (aOR, 0.494; 95% CI, 0.488-0.501), or ostomies (aOR, 0.529; 95% CI, 0.512-0.546). CONCLUSIONS Even without a cost barrier, significant disparities were found in breast cancer screening participation, especially in women with severe disabilities and brain-related and/or mental disabilities. Policy efforts, such as ensuring the accessibility of information and equipment, transportation support, and access to a usual source of care, should be made to decrease this disparity.

中文翻译：

---

残疾妇女和非残疾妇女之间的乳腺癌筛查差异：韩国的一项国家数据库研究。

背景技术残障人士之间的健康差异仍然未被充分认识。本研究的目的是调查：1）残疾妇女与非残疾妇女相比，乳腺癌筛查率是否存在差异；2）乳腺癌筛查率是否根据残疾的类型和严重程度而有所不同；3）根据残疾状况随时间推移进行乳腺癌筛查差异的趋势。方法使用韩国的有关残疾状况的国家管理数据库和国家癌症筛查计划，根据残疾的类型和严重程度计算年龄标准化的参与率。结果残疾个体乳腺癌筛查的年龄标准化率从2006年的30.2％增加到53。2015年为7％（变化为+ 23.5％），而没有残疾的人的比例从29.3％增加到60.1％（变化为+ 30.8％）。通常，残疾与乳腺癌筛查率略低有关（校正比值比[aOR]为0.824； 95％CI为0.820-0.828）。但是，严重残疾女性（aOR为0.465; 95％CI为0.461-0.469）和自闭症女性（aOR为0.235; 95％CI为0.143-0.388），肾功能衰竭（aOR为0.342）的筛查率特别低。 ; 95％CI，0.337-0.348），脑损伤（aOR，0.349; 95％CI，0.346-0.352），智力障碍（aOR，0.403; 95％CI，0.397-0.410），精神障碍（aOR，0.494; 95） ％CI，0.488-0.501）或造口术（aOR，0.529； 95％CI，0.512-0.546）。结论即使没有成本障碍，在乳腺癌筛查参与方面也发现了巨大差异，特别是在患有严重残疾和与脑有关和/或精神残疾的妇女中。为了减少这种差距，应该做出政策上的努力，例如确保信息和设备的可访问性，运输支持以及获得常规护理资源的机会。