Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Mataram, Mataram 83125, Indonesia.
International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
Int J Environ Res Public Health. 2022 Aug 2;19(15):9465. doi: 10.3390/ijerph19159465.
It is well established that access to preventative care, such as breast or cervical cancer screening, can reduce morbidity and mortality. Certain groups may be missed out of these healthcare services, such as women with disabilities, as they face many access barriers due to underlying inequalities and negative attitudes. However, the data have not been reviewed on whether women with disabilities face inequalities in the uptake of these services. A systematic review and meta-analysis were conducted to compare the uptake of breast and cervical cancer screening in women with and without disabilities. A search was conducted in July 2021 across four databases: PubMed, MEDLINE, Global Health, and CINAHL. Quantitative studies comparing the uptake of breast or cervical cancer screening between women with and without disabilities were eligible. Twenty-nine studies were included, all from high-income settings. One third of the 29 studies (34.5%, 10) were deemed to have a high risk of bias, and the remainder a low risk of bias. The pooled estimates showed that women with disabilities have 0.78 (95% CI: 0.72-0.84) lower odds of attending breast cancer screening and have 0.63 (95% CI: 0.45-0.88) lower odds of attending cervical cancer screening, compared to women without disabilities. In conclusion, women with disabilities face disparities in receipt of preventative cancer care. There is consequently an urgent need to evaluate and improve the inclusivity of cancer screening programs and thereby prevent avoidable morbidity and mortality.
众所周知，获得预防保健服务，如乳腺癌或宫颈癌筛查，可以降低发病率和死亡率。某些群体可能会被这些医疗服务所忽视，例如残疾妇女，因为她们由于潜在的不平等和负面态度而面临许多获得服务的障碍。然而，尚未对残疾妇女在接受这些服务方面是否面临不平等进行审查。本研究进行了一项系统评价和荟萃分析，以比较有和无残疾妇女接受乳腺癌和宫颈癌筛查的情况。于 2021 年 7 月在四个数据库中进行了检索：PubMed、MEDLINE、全球健康和 CINAHL。纳入了比较有和无残疾妇女乳腺癌或宫颈癌筛查接受情况的定量研究。共纳入 29 项研究，均来自高收入环境。29 项研究中有 10 项（34.5%）被认为存在高偏倚风险，其余研究则存在低偏倚风险。汇总估计表明，与无残疾妇女相比，残疾妇女接受乳腺癌筛查的可能性低 0.78（95%CI：0.72-0.84），接受宫颈癌筛查的可能性低 0.63（95%CI：0.45-0.88）。总之，残疾妇女在获得预防癌症护理方面存在差异。因此，迫切需要评估和提高癌症筛查计划的包容性，从而预防可避免的发病率和死亡率。
