Journal of Medical Screening > Volume 16, Number 2 > Pp. 85-90

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Original Articles

Variation in the cervical cancer screening compliance among women with disability

Long-Sheng ChenMSc, Research Associate , Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan; Bureau of National Health Insurance, Taipei, Taiwan

Yiing-Jenq ChouMD PhD, Professor , Institute of Public Health, National Yang-Ming University, Taipei, Taiwan

Jen-Huoy TsayPhD, Assistant Professor , Department of Social Work, National Taiwan University, Taipei, Taiwan

Cheng-Hua LeeMD Dr PhD, Professor, Vice President Bureau of National Health Insurance , Bureau of National Health Insurance, Taipei, Taiwan; Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan

Pesus ChouPhD, Professor , Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan

Nicole HuangPhD, Associate Professor  , Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan

Correspondence to: Nicole Huang, Institute of Hospital and Health Care Administration, National Yang-Ming University, Room 101, The Medical Building, 155, Sec. 2, Li-Nong St., Beitou, Taipei City 112, Taiwan, R.O.C; syhuang{at}ym.edu.tw

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Objective To investigate the relationship between the level of disability and regular Pap smear testing among women in Taiwan and explore how this relationship may vary with the various levels of physician availability.

Methods This population-based cohort study followed a total of 5,469,581 women from Taiwan, who were 30 years old or older in 2001 and covered the period January 2001 to December 2003. Of the total study population, 184,701 individuals were women with disability. Gynecologist-obstetrician/general practitioner to female population ratio was used as an indicator of physician availability. Multiple logistical regression models were used.

Results After adjusting for age, socioeconomic status, racial group, residence area and physician availability, women with severe disability (OR = 0.38; 95% CI: 0.38, 0.39) were the least likely to undergo Pap smear testing. Women with moderate disability (OR = 0.59; 95% CI: 0.58, 0.60) and mild disability (OR = 0.88; 95% CI: 0.86, 0.89) were also significantly less likely to undergo a routine test than women without disability. Women residing in the areas with the greatest physician availability (OR = 0.93; 95% CI: 0.93, 0.94) were significantly less likely to undergo a Pap test than those in the areas with the lowest level of resource availability. The disparity in routine screening between women with and without disability remained across the different levels of physician availability.

Conclusions In Taiwan, women with disability were found to be at higher risk of lower compliance than women without disability. The gap between women with and without disability persisted across different levels of physician availability.

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