Mammography usage with relevant factors among women with mental disabilities in Taiwan: a nationwide population-based study.
Severe mental disability slashes mammography use—build caregiver education and systemic outreach into adult plans.
01Research in Context
What this study did
Yen et al. (2015) looked at every woman in Taiwan who has a mental disability and is aged 50-69. They checked national records to see who had a mammogram in the past two years.
The team counted how many women got screened and asked what made it harder or easier. They looked at disability level, income, and schooling.
What they found
Only 8.8 out of every 100 women with mental disabilities had a mammogram. That is far below the national goal of 30 percent.
Severe disability cut the odds of screening by two-thirds. Low income and low education added extra barriers.
How this fits with other research
Miltenberger et al. (2013) interviewed caregivers and heard the same story: families did not know the test was needed and feared the exam would upset the woman. Their qualitative work foreshadows the low numbers Suh-May later counted.
Weng et al. (2011) used the same Taiwan database for kids’ fluoride varnish and found an almost identical 9 percent uptake. The pattern repeats—preventive care reaches fewer than 1 in 10 people with disabilities.
Heald et al. (2020) and Shawler et al. (2021) show the same gap in dental care for children with ASD. Lower IQ predicts lower access, echoing how severe mental disability blocks mammography.
Why it matters
If you serve adults with developmental disabilities, add breast-screening to your health checklist. Teach caregivers why the test matters, walk them through the steps, and ask the doctor for a short social story. One extra page in the ISP could save a life.
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02At a glance
03Original abstract
Women with mental illness are at increased risk of developing and dying from breast cancer and are thus in urgent need of breast cancer preventive care. This study examined the use of screening mammography by Taiwanese women with mental disabilities and analyzed factors affecting this use. 17,243 Taiwanese women with mental disabilities aged 50-69 years were retrospectively included as study subjects. Linked patient data were obtained from three national databases in Taiwan (the 2008 database of physically and mentally disabled persons, the Health Promotion Administration's 2007-2008 mammography screening data, and claims data from the National Health Insurance Research Database). Besides descriptive statistics and bivariate analysis, logistic regression analysis was also performed to examine factors affecting screening mammography use. The 2007-2008 mammography screening rate for Taiwanese women with mental disabilities was 8.79% (n=1515). Variables that significantly influenced screening use were income, education, presence of catastrophic illness/injury, severity of mental disability, and usage of other preventive care services. Screening was positively correlated with income and education. Those with catastrophic illness/injury were more likely to be screened (odds ratio [OR], 1.40; 95% CI=1.15-1.72). Severity of disability was negatively correlated with screening, with very severe, severe, and moderate disability being associated with 0.34-0.69 times the odds of screening as mild disability. In Taiwan, women with mental disabilities receive far less mammography screening than women in general.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.10.052