Pap, mammography, and clinical breast examination screening among women with disabilities: A systematic review

Elena M. Andresen, Jana J. Peterson-Besse, Gloria L. Krahn, Emily S. Walsh, Willi Horner-Johnson, Lisa I. Iezzoni

Research output: Contribution to journalArticlepeer-review

64 Scopus citations


Background: Research has found some disparities between U.S. women with and without disabilities in receiving clinical preventive services. Substantial differences may also exist within the population of women with disabilities. The current study examined published research on Pap smears, mammography, and clinical breast examinations across disability severity levels among women with disabilities. Methods: Informed by an expert panel, we followed guidelines for systematic literature reviews and searched MEDLINE, PsycINFO, and Cinahl databases. We also reviewed in-depth four disability- or preventive service-relevant journals. Two reviewers independently extracted data from all selected articles. Findings: Five of 74 reviewed publications of metall our inclusion criteria and all five reported data on Pap smears, mammography, and clinical breast examination. Articles classified disability severity groups by functional and/or activity levels. Associations between disability severity and Pap smear use were inconsistent across the publications. Mammography screening fell as disability level increased according to three of the five studies. Results demonstrated modestly lower screening, but also were inconsistent for clinical breast examinations across studies. Conclusion: Evidence is inconsistent concerning disparities in these important cancer screening services with increasing disability levels. Published studies used differing methods and definitions, adding to concerns about the evidence for screening disparities rising along with increasing disability. More focused research is required to determine whether significant disparities exist in cancer screening among women with differing disability levels. This information is essential for national and local public health and health care organizations to target interventions to improve care for women with disabilities.

Original languageEnglish (US)
Pages (from-to)e205-e214
JournalWomen's Health Issues
Issue number4
StatePublished - Jul 2013

ASJC Scopus subject areas

  • Health(social science)
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Maternity and Midwifery


Dive into the research topics of 'Pap, mammography, and clinical breast examination screening among women with disabilities: A systematic review'. Together they form a unique fingerprint.

Cite this