http://news.excite.com/news/r/011026/17/health-screening
Fri, Oct 26 5:20 PM EDT
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.
By Charnicia E. Huggins
© 2001 Reuters Limited