Disparities in the diagnosis, treatment, and survival rate of cervical cancer among women with and without disabilities
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Authors
Choi, Jin Young
Yeob, Kyoung Eun
Hong, Seung Hwa
Kim, So Young
Jeong, Eun-Hwan
Shin, Dong Wook
Park, Jong Heon
Kang, Gil-won
Kim, Hak Soon
Park, Jong Hyock
Issue Date
2022-01-19
Type
Article
Language
en_US
Keywords
Cervical Cancer , Disability , Stage , Treatment , Survival
Alternative Title
Abstract
Introduction:
Not much is known regarding the disparities in cancer care between women with and without disabilities.
Objectives:
The aim of this study was to investigate the potential disparities in the diagnosis, treatment, and survival of women with cervical cancer with and without disabilities.
Methods:
We performed a retrospective cohort study and linked the National Disability Database, Korean Central Cancer Registry, and Korean National Health Insurance claims database. Charlson comorbidity index was used for adjusting the comorbidity. The study population comprised 3 185 women with disabilities (physical/brain, communication, mental, cardiopulmonary, and other impairment) who were diagnosed with cervical cancer and 13 582 age- and sex-matched women without disability who were diagnosed with cervical cancer for comparison.
Results:
Distant metastatic stage (7.7% vs 3.7%) and unknown stage (16.1% vs 7.0%) were more common in cervical cancer women with grade 1 disabilities, compared with women without disabilities. Women with cervical cancer with disabilities were less likely to undergo surgery (adjusted odds ratio (aOR) 0.81, 95% confidence interval (CI) 0.73–0.90) or chemotherapy (aOR 0.86, 95% CI 0.77–0.97). Lower rate of surgery was more evident in patients with physical/brain impairment (aOR 0.46, 95% CI 0.37–0.58) and severe mental impairment (aOR 0.57, 95% CI 0.41–0.81). The overall mortality risk was also higher in patients with disabilities (adjusted hazard ratio (aHR) 1.36, 95% CI 1.25–1.48).
Conclusion:
Women with cervical cancer with disabilities, especially with severe disabilities, were diagnosed at later stages, received less treatment, and had higher mortality rates, compared with patients who lacked disabilities. Social support and policies, along with education for women with disabilities, their families, and healthcare professionals, are needed to improve these disparities.
Description
Citation
Choi, J. Y., Yeob, K. E., Hong, S. H., Kim, S. Y., Jeong, E. H., Shin, D. W., Park, J. H., Kang, G. W., Kim, H. S., Park, J. H., & Kawachi, I. (2021). Disparities in the Diagnosis, Treatment, and Survival Rate of Cervical Cancer among Women with and without Disabilities. Cancer control : journal of the Moffitt Cancer Center, 28, 10732748211055268. https://doi.org/10.1177/10732748211055268
Publisher
Cancer Control : Journal of the Moffitt Cancer Center