PRP150: Rates of Mammography and Colonoscopy Screening for Individuals with Visual Impairment

Shira Winter; Raymond Van Cleve, PhD, MS; Caroline Madrigal, PhD, RN


Context: The U.S. Preventative Services Task Force (USPSTF) recommends that mammography every 2 years for women above age 50, with variation for individual preference and characteristics for starting mammogram at age 40 and screening annually verses bi-annually, and colorectal cancer screenings for most adults between ages 50-75. People living with visual impairment have increased difficulty accessing primary care services due to transportation issues, cost of care, lack of insurance coverage, and provider denial to see them. Objective: The aim of this study is to assess the magnitude of the association between living with visual impairment and accessing cancer screenings (mammography and colonoscopy) at recommended intervals, as well as other demographic factors that may influence screening rates. Study Design: This secondary data analysis uses adjusted logistic regression to determine if there is a correlation between self-reported visual impairment and rates of mammography and colonoscopy at the intervals recommended by the USPSTF. Our model included demographic indicators, having a history of cancer, and smoking, all of which have been identified as characteristics that may influence rates of screening. Dataset: We analyzed data from the Center for Disease Control and Prevention’s 2018 Behavioral Risk Factor Surveillance System for people across the United States. For mammograms, we examined women, ages 50-75. For colonoscopy, we examined men and women ages 50-75. Population studied: Respondents eligible for screenings indicated above. Outcome Measures: 1) Mammography within the last two years; 2) colonoscopy within the last 10 years. We include the following covariates: smoking status, race/ethnicity, insurance status, history of cancer, and income. Results: Preliminary results show that visual impairment is associated with lower odds of mammography screening at regular intervals (OR=0.74, p<0.00), but not with odds of colonoscopy (OR=0.9, p=0.1). Race, insurance type, and income are also significantly correlated with screening rates. Conclusions: These findings suggest that people living with visual impairment face both structural and financial barriers to preventative services. Efforts should be made to ensure accessibility of preventative services, including cancer screenings, regardless of visual ability. Findings suggest the need for increased attention and action to reduce cancer screening disparities for all populations.

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