Women with Congenital Physical Disabilities Screen for Cervical Cancer Less Than Women with Acquired Physical Disabilities·

Background: Women with physical disabilities screen less for cervical cancer than do non-disabled women. The origin of disability and the life course timing of becoming disabled shape women's engagement with the healthcare system, including assumptions about cervical cancer risk and the need for screening. We evaluated cervical cancer screening (CCS) rates by physical disability type (congenital vs. acquired), age, race/ethnicity, and any college attendance.<br><br>Methods: This cross-sectional study used multi-institutional Truveta electronic health records and selected women aged 20 to 60 in 2016 who had had at least two health care visits between January 1, 2017, and December 31, 2022; a six-year time frame in which all would have been expected to screen at least once. We assessed CCS by laboratory codes. Diagnostic codes identified with women with congenital (cerebral palsy and spina bifida) and acquired (multiple sclerosis, spinal cord injury, and hemi-, para-, and quadriplegia) physical disabilities.&nbsp;We used t-tests, Wilcoxon, Chi-Square, or Fisher's exact test as appropriate. We estimated conditional average treatment effects from multivariable logistic regression with Firth correction for bias and Tukey tests.&nbsp;<br><br>Findings: We identified 5874 WCPD and 9853 WAPD meeting the eligibility requirements. WAPD participated in CCS significantly more than WCPD (66.8% vs 57.8%, p&lt;0.001). CCS among WAPD and WCPD was not impacted by race or ethnicity. Age significantly predicted CCS for each population, but more extensively for WAPD. Attending college was a noteworthy predictor of CCS: WCPD (aOR=2.62 (2.27, 3.02), p&lt;0.001) and WAPD (aOR=1.76 (1.57, 1.96), p&lt;0.001). WAPD had significantly higher odds than WCPD for CCS by all age groups and college attendance.<br><br>Interpretation: We show that combining all women with physical disabilities into one category is insufficient to understand the CCS patterns of women with physical disabilities. With this new understanding, targeted interventions can be tailored for specific groups.