Abstract C149: Prevalence of breast, cervical, and colorectal cancer screening among adults according to disability type and difficulty severity, United States, 2021 and 2023

Abstract Background: Cancer screening is critical for early detection and improved survival. Research indicates adults with disabilities are less likely to receive cancer screening services. Disabilities encompass diverse needs; however, few studies considered various disability domains and severity levels. This study examined the prevalence of breast, cervical, and colorectal cancer screening across multiple disability domains and severity levels using nationally representative data. Methods: We analyzed pooled data from 2021 and 2023 National Health Interview Survey (NHIS) to examine screening adherence according to the US Preventative Services Task Force recommendations for breast, cervical, and colorectal cancers. Disability status was defined according to severity levels (“Substantial Difficulty”, “Some Difficulty”, and “None”) on the Washington Group Composite Disability Indicator across six functional domains (vision, hearing, mobility, cognition, communication, and self-care). Logistic regression models estimated adjusted prevalence ratios (aPRs) comparing cancer screening by disability status, adjusting for survey year, age, sex (for colorectal cancer only), race/ethnicity, annual income, health insurance type, education level, marital status, geographic region, and urbanicity. Results: A total of n=1,712 (2.4%), n=1,147 (2.0%), and n=3,106 (4.4%) individuals eligible for breast, cervical, and colorectal screening were classified as having a disability. Mammography prevalence was lower among women with substantial difficulties for self-care (52%, aPR= 0.69, 95% CI: 0.58, 0.82), vision (62%, aPR= 0.83, 95% CI: 0.75, 0.91), and mobility (68%, aPR=0.89, 95%CI: 0.85, 0.93) compared to those reporting no difficulties (78%-79%). Cervical cancer screening prevalence was lower among those with substantial difficulties for self-care (31%, aPR= 0.59, 95% CI: 0.46, 0.75), communication (33%, aPR= 0.61, 95% CI: 0.47, 0.80), vision (54%, aPR= 0.85, 95% CI: 0.76, 0.96), and mobility (57%, aPR= 0.87, 95% CI: 0.81, 0.95) compared to women reporting no difficulties (71%-72%). Colorectal cancer screening with stool testing was higher among those with some difficulties for vision (18%, aPR= 1.08, 95% CI: 1.00, 1.17), mobility (19%, aPR= 1.12, 95% CI: 1.03, 1.21), self-care (24%, aPR= 1.28, 95% CI: 1.11, 1.47), and among those with substantial mobility difficulties (22%, aPR= 1.24, 95% CI: 1.12, 1.38) compared to those reporting no difficulties (16%-17%). For colonoscopy, prevalence was higher among those with some cognitive difficulties (67%, aPR= 1.07, 95% CI: 1.04, 1.09) compared to those with no cognitive difficulties (63%). Conclusion: Cancer screening disparities were observed by disability domain for breast and cervical cancer screening, particularly for self-care, communication, mobility, and vision. Conversely, stool testing was higher across several domains, potentially highlighting home-based and self-sampling testing modalities as accessible methods to improve screening among individuals with disabilities. Citation Format: Natalia Mazzitelli, Jessica Star, Kinsey Meggett, Xuesong Han, Priti Bandi. Prevalence of breast, cervical, and colorectal cancer screening among adults according to disability type and difficulty severity, United States, 2021 and 2023 [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C149.