The use of Pap smear and its influencing factors among women with disabilities in Taiwan.
Pap smear use among Taiwanese women with disabilities is critically low, and the most disabled are the least screened.
01Research in Context
What this study did
Huang et al. (2012) looked at one year of Taiwan health insurance files. They counted how many women with disabilities got a Pap smear in 2008.
The team split the women by age, income, schooling, marriage, diabetes, and disability level. No one got an intervention; the study was pure numbers.
What they found
Only eight out of every 100 disabled women had the test. The lowest use was among older, poor, less-educated, unmarried, diabetic, or severely disabled women.
Women with intellectual or severe disabilities were the least likely to be screened.
How this fits with other research
Lin et al. (2010) asked 508 women with ID the same question two years earlier and got 22% ever-screened. The new 8% one-year rate shows the gap is even bigger than we thought.
Yen et al. (2015) later narrowed the lens to mental disabilities and saw 11% uptake, confirming the target paper’s warning that this subgroup is especially left out.
Kung et al. (2012) looked at all free preventive services in the same 2008 data and found only 16% use, backing the idea that Pap smears are not the lone missed service.
Why it matters
If you serve adults with disabilities, cancer screening is probably falling through the cracks. Add visual prompts, caregiver training, or phone reminders to your plan. Track who is due and bring the clinic to them when possible. A five-minute script with staff or families can save a life.
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02At a glance
03Original abstract
Cervical cancer is a prevalent cancer among Taiwanese women, and can be effectively cured if diagnosed early. Therefore, cervical cancer is worthy of preventive health screening. Due to physical and psychological barriers, patients with disability may be unable to express their physical complaints accurately, thus reducing their access to health care; some may not even receive proper preventive health care or medical treatment. This study investigates the utilization of Pap smear among women with disability in Taiwan and its influencing factors. With women aged 30 and over as the study subjects, this retrospective cohort study is conducted based on the database of the Ministry of the Interior, Taiwan, 2008, combined with information gathered between 2006 and 2008 regarding preventive health care and health insurance medical claims data from the Bureau f Health Promotion and the National Health Research Institutes, respectively. The frequency of Pap smears and the percentage differences of each variable are examined using the 2× tests to check for statistical significance. Finally, logistic regression analysis is used to examine the factors influencing the use of Pap smears. The results revealed that among disabled women aged 30 and over, the use of Pap smears was 7.71% in 2008. Disabled women with the following characteristics had lower use levels regarding Pap smears: greater age, residing in areas of higher urbanization, lower income, lower education levels, unmarried, not diagnosed with cancer, diagnosed with diabetes, and with severe disability levels. Disabled women with hearing impairments or mental retardation were possessed of the highest and lowest probabilities of using Pap smear, respectively. The recommendations of this study include: (1) provide physicians with a varying pricing scheme and incentives for Pap smear based on the type or severity of disability; (2) proactively encourage gynecologist and obstetricians to conduct regular and convenient Pap smear on disabled women; and (3) target disabled women in low usage groups, and improve their knowledge of Pap smear.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.09.016