Bridging the Gap: Addressing Screening Disparities in Cervical Cancer Among Women with Physical Disabilities, finds study

Cervical cancer screening is a vital public health intervention, yet women with physical disabilities (WWPD) face disparities in accessing this screening. Existing research indicates that WWPD are 48% less likely to receive cervical cancer screening compared to women without physical disabilities. Various factors contribute to this disparity, including lack of accessibility, cultural incompetency among healthcare professionals, and assumptions that WWPD are not sexually active and therefore do not require screening. The prevalence of physical disabilities among women is steadily increasing, with 51% of the disabled population having physical disabilities. Human papillomavirus (HPV) is the primary cause of cervical cancers transmitted sexually through skin-to-skin contact.

Alternative Screening Methods for Women with Physical Disabilities

Self-screening for primary HPV using self-sampling kits has been implemented in European countries as an alternative screening method. This method has shown increased participation among those least likely to undergo conventional screening methods. In the US, WWPD have not been sufficiently engaged in public health efforts to improve access to cervical screening services tailored to their needs. Current surveys do not adequately capture the screening prevalence among WWPD due to limitations in survey formats, hindering their voices from informing public health interventions effectively.

Experiences with Novel Self-Sampling Devices for HPV Screening

Recent qualitative interview study was conducted with WWPD using interpretivist and phenomenological approaches to explore their experiences with novel self-sampling devices for primary HPV screening and traditional speculum-based cervical cancer screening. Participants included key informants and community members who tested different self-sampling kits. Findings revealed that WWPD often had negative experiences with in-office speculum examinations, citing disability-specific factors that impacted their experiences, such as clinic environment, lack of accommodations, and perceived differential treatment by healthcare staff.

Preference for At-Home Self-Sampling among Women with Physical Disabilities

On the other hand, participants found at-home self-sampling to be comfortable, convenient, and empowering. Self-sampling eliminated barriers associated with in-office screening, such as transportation challenges and the need for specific accommodations. Most WWPD expressed a preference for self-sampling over traditional screening methods and believed it would increase their likelihood of getting screened regularly.

Advantages of Self-Sampling in Addressing Barriers to Screening

The study highlighted the potential of self-sampling to address disability-specific barriers to cervical cancer screening and emphasized the need for clinician training in disability health to ensure equitable screening practices. By providing options for self-sampling kits, individuals with disabilities can have greater control over their health and screening experiences. Educating patients on the accuracy and procedure of self-sampling is crucial to ensure confidence and adherence to screening recommendations. The study acknowledges limitations in recruitment pathways and participant demographics, emphasizing the intersectionality of gender, disability, race, and ethnicity in shaping screening experiences. Overall, the findings suggest that self-sampling could be a promising strategy to increase cervical cancer screening participation among WWPD and other underscreened populations. This research contributes to ongoing efforts to promote equitable and inclusive health practices for all individuals, regardless of ability status.

Key Points

- Women with physical disabilities (WWPD) face significant disparities in accessing cervical cancer screening, being 48% less likely to receive screening compared to women without physical disabilities.

- Factors contributing to these disparities include lack of accessibility, cultural incompetency among healthcare professionals, and misconceptions about the sexual activity and screening needs of WWPD.

- Self-screening for primary HPV using self-sampling kits has shown increased participation among groups least likely to undergo traditional screening methods, but WWPD in the US have not been sufficiently engaged in tailored screening services.

- A qualitative study on WWPD's experiences with self-sampling devices revealed negative experiences with speculum examinations due to disability-specific factors, highlighting the need for more accommodating screening methods.

- WWPD expressed a preference for at-home self-sampling over traditional methods, citing comfort, convenience, and empowerment, and believed it would increase their likelihood of regular screening.

- Self-sampling was found to address disability-specific barriers to screening and emphasized the importance of clinician training in disability health to ensure equitable screening practices, indicating it could be a promising strategy to increase screening participation among underscreened populations.

Reference –

A. Vinson et al. (2025). Cervical Cancer Screening In Women With Physical Disabilities. *JAMA Network Open*, 8. https://doi.org/10.1001/jamanetworkopen.2024.57290.