Determinants of cervical cancer screening among a community-based sample of women with intellectual disabilities

Rates of receipt of cervical cancer screening among women with intellectual disabilities are reported to be the worst for any population subgroup in the United States. While barriers to receipt of preventive care for this population are well-established, less is known about the determinants to care. We collected medical record data from 2006-2010 for a sample of women with intellectual disabilities (n=199) living in the community across one Southeastern state in the United States. We found rates of receipt of Pap tests were markedly lower than the Healthy People targets or rates of receipt of women without disabilities. 53% of women aged 21 years and older received a Pap test over a 3-year period in 2008, 2009, or 2010. Women with intellectual disabilities who lived in residential facilities, in rural communities, and who had received a physical exam, had better rates of receipt of care compared to other women with intellectual disabilities. Assertive measures are needed to increase the number of women with intellectual disabilities receiving cervical cancer screening according to clinical guidelines. Our findings indicate that women living at home with families may be especially in need of intervention. Our findings also suggest that disability and health advocates could encourage women with intellectual disabilities to receive annual physicals to improve rates of receipt of Pap tests.