Adherence to US Preventive Services Task Force recommendations for breast and cervical cancer screening for women who have a spinal cord injury

Abstract

Context: Women with spinal cord injury (SCI) may face barriers that result in disparities in receipt of recommended mammography and Papanicolaou testing.

Setting: South Carolina.

Participants: South Carolina women with SCI were identified using International Classification of Diseases codes in 2000–2010 Medicaid and Medicare billing data.

Outcome measures: Receipt of mammography and Pap testing was determined using procedure billing codes. Partial proportional odds models were estimated to examine the association between SCI and adherence with screening recommendations from the United States Preventive Services Task Force. Each individual's screening experience was classified as full adherence, partial adherence, or no screening.

Results: The cohort for mammography consisted of 3,173 women with SCI and 6,433 comparison women without SCI. The cohort for Pap testing consisted 5,025 women with SCI and 9,538 comparison women. Women with SCI were less likely to have full adherence with mammography recommendations (aOR = 0.69, 95% CI 0.64, 0.76) and Pap test recommendations (aOR = 0.53, 95% CI 0.49, 0.57). They were more likely to have no mammography screening (aOR = 1.44, 95% CI 1.33, 1.57) and no Pap testing (aOR = 1.89, 95% CI 1.77, 2.03) than women without SCI.

Conclusion: Using longitudinal data with multiple outcome levels, women with SCI were less likely to be fully adherent with receipt of recommended breast and cervical cancer screenings and more likely to have no screenings during the eligible years when compared to women without SCI.

Keywords:

• Spinal cord injuries, Mammography, Papanicolaou test, Healthcare disparities, Cancer screening

Acknowledgment

This work was supported by the Centers for Disease Control and Prevention (CDC), National Center for Birth Defects and Developmental Disabilities, (Grant # 1U01DD001007).

Disclaimer statements

Contributors None.

Funding This research was funded by the Centers for Disease Control and Prevention, cooperative agreement U01 RFA-DD-12-006.

Conflict of interest All authors report no conflicts of interest.

Ethics approval None.

ORCID

Suzanne W. McDermott http://orcid.org/0000-0003-1517-5033

Notes

* Research Data Assistance Center: This is a Center for Medicare and Medicaid (CMS) contractor that provides free assistance to academic, government and non-profit researchers interested in using Medicare and/or Medicaid data for their research.