Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
Public Health Agency, Belfast, Northern Ireland.
J Med Screen. 2020 Dec;27(4):194-200. doi: 10.1177/0969141319888553. Epub 2019 Nov 21.
Despite a growing body of evidence suggesting inequalities in breast cancer screening uptake in the United States for women with disabilities, few attempts have been made to examine whether this association applies to the United Kingdom. We conducted the first population-wide study investigating the impact of disability on uptake of breast cancer screening in Northern Ireland.
Breast screening records extracted from the National Breast Screening System were linked to the Northern Ireland Longitudinal Study. This identified a cohort of 57,328 women who were followed through one complete three-year screening cycle of the National Health Service Breast Screening Programme in Northern Ireland. The presence of disability was identified from responses to the 2011 Census.
Within this cohort, 35.8% of women reported having at least one chronic disability, and these individuals were 7% less likely to attend compared with those with no disability (odds ratio 0.93; 95% confidence interval 0.89-0.98). Variation in the degree of disparity observed was evident according to the type and number of comorbid disabilities examined.
This is the first population-wide study in Northern Ireland to identify disparities in breast screening uptake for women with chronic disabilities, in particular, those with multimorbidity. This is of particular concern, given the projected rise in the prevalence of disability associated with the ageing population.
尽管越来越多的证据表明,美国残疾女性在接受乳腺癌筛查方面存在不平等现象,但很少有人试图研究这种关联是否适用于英国。我们进行了首次全人群研究,调查了北爱尔兰残疾对乳腺癌筛查参与度的影响。
从国家乳房筛查系统中提取的乳房筛查记录与北爱尔兰纵向研究相关联。这确定了一个队列,包含 57328 名女性,她们在北爱尔兰国民保健服务乳房筛查计划的一个完整三年筛查周期中接受了随访。残疾状况是通过 2011 年人口普查的回答确定的。
在这个队列中,35.8%的女性报告至少有一种慢性残疾,与没有残疾的女性相比,这些人参加的可能性低 7%(优势比 0.93;95%置信区间 0.89-0.98)。根据所检查的合并残疾的类型和数量,观察到的差异程度存在明显差异。
这是北爱尔兰首次全人群研究,确定了慢性残疾妇女(特别是多病共存的妇女)在接受乳腺癌筛查方面的差异。鉴于与人口老龄化相关的残疾患病率预计会上升,这尤其令人担忧。