Papanicolaou smear screening of women with intellectual disabilities: a cross-sectional survey in Taiwan.
Most women with intellectual disability in Taiwan have never had cervical-cancer screening, and unmarried women are the most overlooked.
01Research in Context
What this study did
Lin et al. (2010) asked 508 women with intellectual disability in Taiwan if they had ever had a Pap smear.
They also wrote down each woman’s age, marital status, and medical history.
The team wanted to see who was missing cervical-cancer screening.
What they found
Only 22 out of every 100 women had ever had the test.
Unmarried women and women who had not had a tubal ligation were the least likely to be screened.
How this fits with other research
Huang et al. (2012) looked again two years later. They included all disabled women, not only those with ID, and found an even lower rate: 8%.
Yen et al. (2015) used national records and showed the same group—women with intellectual or mental disabilities—had only an 11% screening rate. The later study extends the 2010 finding by showing older age and greater disability severity make uptake worse.
Kung et al. (2012) and Lai et al. (2014) show the problem is wider: free dental cleanings and other preventive care are also skipped. Together the papers paint one picture—people with disabilities in Taiwan rarely receive routine health care.
Why it matters
If you serve adults with ID, add Pap-smear status to your health checklist. Ask the doctor, schedule the appointment, and use picture stories or social stories to teach the woman what will happen. A five-minute prompt can save a life.
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Join Free →Open the health file for every adult female client and write ‘Pap smear due’ if no date is listed—then call the doctor.
02At a glance
03Original abstract
Although little is known about the incidence of cervical cancer in women with intellectual disabilities (ID), Pap smear screening is an effective public health program to prevent cervical cancer to this group of people. The purposes of this study were to identify and evaluate the factors regarding the utilization of the Pap smears in women with ID seen in the preventive health screening program. We employed a cross-sectional survey "2009 National Survey on Preventive Health Use and Determinants among People with Disabilities", with the study sample 508 women with ID (aged > or =15 years) participated in the research in Taiwan. Results showed that there were 22.1% women with ID had ever used Pap smear screening previously and mean age of the first screening was nearly 40 years old. Comparing to the general population in Taiwan, the ID women at age group <35 years was less likely to use screening and the age group > or =35 years was more likely to use Pap smears than did the general women. Finally, a logistic regression analysis showed that marital status and had experience of accepted tubal ligation surgery were two factors which predicted Pap smear test use in the study. Those women with ID who had marital status were 8.99 times (95% CI=1.65-49.15) more likely than those had not marital status to use Pap smear test. Women with ID had experience on tubal ligation surgery were 10.48 times (95% CI=1.40-78.26) more likely to use Pap smear test than their counterparts. This study highlights that to acknowledge the rights of women with ID to access Pap smear screening service, health professionals will need to become more flexible and competent in the service that they provide.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2009.10.001