More MS news articles for Oct 2001

Non-Mobile Women with MS Miss Cancer Screening

Fri, Oct 26 5:20 PM EDT
By Charnicia E. Huggins

NEW YORK (Reuters Health) - Women with multiple sclerosis (MS) who are also severely impaired in their ability to walk are less likely than their fully mobile peers to participate in breast and cervical cancer screenings and other preventive health services, according to the results of a new study.

"Patients with disabilities are less likely to receive screening tests that require a patient to stand up or to get on an examination table, such as mammograms and Pap smears," Dr. Eric Cheng of the University of California, Los Angeles, told Reuters Health.

"(However,) just because a woman has a disability doesn't mean that she can't also get breast cancer," he said. "These patients are just as deserving of preventive care as the general population."

Cheng and his colleagues investigated the impact of impaired mobility on preventive services use in a study of over 700 women with multiple sclerosis.

They found that non-ambulatory women--those unable to walk one block without a cane, crutch or other aid--reported less use of cervical smear tests, breast examinations and mammography, than did partially and fully ambulatory women.

Furthermore, with only 68% of non-ambulatory women reporting having received a cervical smear test within the past 3 years, this group did not meet the 85% Healthy People 2000 target rate for the test, Cheng's team reports in the October 27th issue of The Lancet.

Partially ambulatory women also fell short of the Healthy People 2000 goal, with only 79% reporting that they received a cervical smear test. Over 90% of the fully ambulatory women, however, said they had received the test.

All of the groups exceeded the Healthy People 2000 rates for breast examinations during the past year and mammography within the past 2 years for women aged 50 years and older. Partially ambulatory women, however, were 80% more likely to report having had a breast examination and more than three times as likely to report having had a mammogram than their non-ambulatory peers. Likewise, fully ambulatory women were more than three times more likely to report having undergone either test, the authors note.

Discrepancies may occur because doctors fail to offer these preventive services to their patients, because patients are reluctant to participate in the "potentially uncomfortable or embarrassing" screenings, or because of a lack of proper equipment or time needed to accommodate impaired individuals, the researchers speculate.

"We need to find the reasons for decreased preventive care in disabled women...(so that) we can design specific remedies," Cheng said.

"It will likely require not only access to specialized exam tables and mammogram equipment, but also education of both doctors and patients," he added.

What's more, these findings may be applicable to men as well as women, according to Cheng.

"We can speculate that men in wheelchairs may have as much trouble getting into position for certain examinations, such as prostate exams, as women getting pelvic exams," he said.

SOURCE: British Medical Journal 2001;323:968-969.
© 2001 Reuters Limited