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Annals of surgical oncology
Feb, 2024;31 (2): 911-919.

Disparities in Breast Cancer Screening Rates Among Adults With and Without Intellectual and Developmental Disabilities.

Muhammad Muntazir Mehdi Khan, Usama Waqar, Muhammad Musaab Munir, Selamawit Woldesenbet, Parit Mavani, Yutaka Endo, Erryk Katayama, Karol Rawicz-Pruszyński, Doreen M Agnese, Samilia Obeng-Gyasi, Timothy M Pawlik
Author Information
  1. Muhammad Muntazir Mehdi Khan: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  2. Usama Waqar: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  3. Muhammad Musaab Munir: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  4. Selamawit Woldesenbet: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  5. Parit Mavani: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  6. Yutaka Endo: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  7. Erryk Katayama: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  8. Karol Rawicz-Pruszyński: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  9. Doreen M Agnese: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  10. Samilia Obeng-Gyasi: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  11. Timothy M Pawlik: Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Tim.Pawlik@osumc.edu. ORCID
PMID: 37857986 DOI: 10.1245/s10434-023-14425-z

Abstract

BACKGROUND: Individuals with intellectual and developmental disabilities may face barriers in accessing healthcare, including cancer screening and detection services. We sought to assess the association of intellectual and developmental disabilities (IDD) with breast cancer screening rates.
METHODS: Data from 2018 to 2020 was used to identify screening-eligible individuals from Medicare Standard Analytic Files. Adults aged 65-79 years who did not have a previous diagnosis of breast cancer were included. Multivariable regression was used to analyze the differences in breast cancer screening rates among individuals with and without IDD.
RESULTS: Among 9,383,349 Medicare beneficiaries, 11,265 (0.1%) individuals met the criteria for IDD. Of note, individuals with IDD were more likely to be non-Hispanic White (90.5% vs. 87.3%), have a Charlson Comorbidity Index score ≤ 2 (66.2% vs. 85.5%), and reside in a low social vulnerability index neighborhood (35.7% vs. 34.4%). IDD was associated with reduced odds of undergoing breast cancer screening (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.74-0.80; p < 0.001). Breast cancer screening rates in individuals with IDD were further influenced by social vulnerability and belonging to a racial/ethnic minority.
CONCLUSIONS: Individuals with IDD may face additional barriers to breast cancer screening. The combination of IDD and social vulnerability placed patients at particularly high risk of not being screened for breast cancer.

Keywords

Cancer screening Healthcare disparities Intellectual and developmental disabilities Race Socioeconomic status

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MeSH Term

Adult
Child
Humans
Aged
United States
Female
Breast Neoplasms
Ethnicity
Early Detection of Cancer
Developmental Disabilities
Medicare
Minority Groups
Journal Article

Word Cloud

Created with Highcharts 10.0.0cancerIDDscreeningbreastindividualsdevelopmentaldisabilitiesrates0vssocialvulnerabilityIndividualsintellectualmayfacebarriersusedMedicareAdultsAmong5%oddsBreastCancerIntellectualBACKGROUND:accessinghealthcareincludingdetectionservicessoughtassessassociationMETHODS:Data20182020identifyscreening-eligibleStandardAnalyticFilesaged65-79yearspreviousdiagnosisincludedMultivariableregressionanalyzedifferencesamongwithoutRESULTS:9383349beneficiaries112651%metcriterianotelikelynon-HispanicWhite90873%CharlsonComorbidityIndexscore≤ 2662%85residelowindexneighborhood357%344%associatedreducedundergoingratioOR7795%confidenceintervalCI74-080p< 0001influencedbelongingracial/ethnic minorityCONCLUSIONS:additionalcombinationplacedpatientsparticularlyhighriskscreenedDisparitiesScreeningRatesWithoutDevelopmentalDisabilitiesHealthcaredisparitiesRaceSocioeconomicstatus

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