People With Disabilities Are Screened Less for Colorectal Cancer

Following cancer screening guidelines can drastically reduce the number of deaths from colorectal cancer. But getting screened is not always easy and straightforward for some populations — especially those with disabilities, according to a recent study published in the American Journal of Preventative Medicine.

By examining the South Carolina Medicaid and Medicare claims, state health plans claims and hospital discharge forms between 2000 and 2009, a group of researchers at the University of Missouri School of Medicine found that while 48 percent of the general public followed screening recommendations for colorectal cancer, only 34 percent of those with intellectual disabilities, 44 percent of those with spinal cord injuries and 46 percent of those with blindness or low vision followed guidelines.

“I think a lot of it has to do with access to the care, and also [the disparity has] a little bit of providers not giving these people the information that they need,” Chelsea Deroche, Ph.D., author on the study said in an interview with CURE.

For example, people with intellectual disabilities may be in a group home that does not put emphasis on preventative screenings. When they go to the doctor, the doctor may not bring up screenings, or the patient might not fully understand. For people with spinal cord injuries, the physical preparation for a colonoscopy can be a limiting factor, and all three of these groups might have barriers to transportation that would actually take them to the tests, Deroche, assistant professor of Biostatistics in the MU Department of Health Management and Informatics and in the Biostatistics and Research Design Unit, mentioned.

Currently, the United States Preventative Services Task Force (USPSTF) recommends that individuals between the ages of 50 and 75 be screened for colorectal cancer. Screening options include: fecal occult blood test every year, sigmoidoscopy every five years, plus a fecal occult blood test every three years or a colonoscopy every ten years.

Deroche said that nearly 60 percent of deaths from colorectal cancer could be avoided if patients adhered to the screening recommendations.

“In five to ten years, I would love to see, disability or not, these screening numbers increasing,” Deroche said, noting that to improve screening in populations of people with disabilities may take a “community effort” that involves caretakers, patients and health care providers.

The research team at the University of Missouri is hoping to expand its research on cancer screenings in people with disabilities, observing screenings for different tumor types — such as breast cancer and cervical cancer – as well as a larger population of patients.

“We want to do a wider study — because we did just do South Carolina — where a general US population to validate what we’ve done here and that these findings are nation-wide,” she said.