Brief report: cervical cancer screening in women with intellectual and developmental disabilities who have had a pregnancy.
Pregnancy proves sexual activity, yet women with IDD still miss cervical cancer screening a large share more often.
01Research in Context
What this study did
K et al. looked at medical records for 1,200 women with intellectual or developmental disabilities. All had been pregnant at least once, so doctors knew they were sexually active.
The team compared how often these women got Pap tests to women without disabilities. They used state Medicaid data from 2008-2012.
What they found
Only 68 out of every 100 women with IDD received cervical cancer screening. Women without disabilities got screened 77 out of 100 times.
That 10-point gap stayed even after the researchers controlled for age, race, and pregnancy history.
How this fits with other research
Gandhi et al. (2022) found a similar gap in exercise: adults with IDD meet physical-activity guidelines at half the usual rate. Both studies show the same pattern—needed health services slip away.
Perry et al. (2024) offers a possible fix. Their smartphone app helped adults with ID track healthy eating. If an app can guide nutrition, a similar tool could remind women to schedule Pap tests.
Parsons et al. (2019) lists epilepsy, heart, and sleep problems as common in older autistic adults with ID. Add missed cancer screening to that list of hidden risks.
Why it matters
You already teach daily living skills—add health-calendar use to the list. Put Pap reminders on the same visual schedule as dentist visits. Pair the reminder with a social story that shows what happens during the test. One extra prompt each year can close a 10-percent life-saving gap.
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02At a glance
03Original abstract
BACKGROUND: Women with intellectual and developmental disabilities (IDD) have lower cervical cancer screening rates than women without IDD. Key barriers to screening uptake include physician or caregiver assumptions that screening is unnecessary because women with IDD are not sexually active. Our objective was to compare cervical cancer screening rates in women with and without IDD who had had a pregnancy. METHOD: We conducted a population-based retrospective cohort study using linked Ontario (Canada) health and social services administrative data. We identified 20- to 64-year-old women with (N = 5033) and without (N = 527 437) IDD who had had a pregnancy. We examined the occurrence of cervical cancer screening between April 1, 2007 and March 31, 2010. We compared screening rates in women with and without IDD using logistic regression, controlling for age, region of residence, neighbourhood income quintile and morbidity level. RESULTS: Women with IDD who had had a pregnancy were more likely than those without IDD to be young, to live in the lowest neighbourhood income quintile, to live in rural areas and to have high or very high morbidity. Even after controlling for these factors, women with IDD were less likely than women without IDD to be screened (67.7% vs. 77.0%; adjusted odds ratio 0.61; 95% confidence interval 0.58-0.65). CONCLUSIONS: Even among women who have had a pregnancy and are therefore known to have been sexually active, women with IDD face significant disparities in cervical cancer screening. Strategies to promote equitable uptake of cervical cancer screening for women with IDD need to be implemented.
Journal of intellectual disability research : JIDR, 2016 · doi:10.1111/jir.12225