• Sara J T Guilcher, Aisha Lofters, Richard H Glazier, Susan B Jaglal, Jennifer Voth, and Ahmed M Bayoumi.
• Canadian Population Health Initiative, Canadian Institute for Health Information, Toronto, Canada; Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. Electronic address: sara.guilcher@utoronto.ca.
• Prev Med. 2014 Oct 1; 67: 193198193-8.

BackgroundWomen with disability may be less likely screened for breast cancer. Research is limited on the extent to which level of disability and multi-morbidity influence screening.MethodsUsing a retrospective population-based cohort study design, we linked administrative and self-reported survey data to identify screening in Ontario. The cohort was identified using two waves of the Canadian Community Health Survey (2005 and 2007/08). Fee codes were used to identify mammography imaging. Rates were examined over a two-year period and compared across level of disability and multi-morbidity.ResultsAmong 10,363 women identified for study inclusion, 4660 reported some level of disability. Women with moderate disability had higher screening rates (71.4%) than women with no disability (62.0%) and women with severe disability (67.9%). We observed an inverse V-shaped relationship between level of disability and screening across all levels of multi-morbidity. In multivariate regression, women with moderate disability had higher odds of being screened compared to women with no disability (OR 1.2 [1.09-1.38]). Women with severe disability had lower odds of being screened compared to women with moderate disability (OR 0.72 [0.63-0.82]) and no disability (OR 0.88 [0.78-0.99]). Women with one chronic condition had higher odds of screening compared to women with no chronic conditions (OR 1.31 [1.17-1.46]).ConclusionsOur findings suggest that severe levels of disability and morbidity are associated with low likelihoods of breast cancer screening.Copyright © 2014. Published by Elsevier Inc.

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