Abstract
Purpose :
Cancer screening can lead to early detection and reduced mortality. Due to barriers in reading, driving, and ambulating, individuals with visual impairment (VI) may participate in cancer screening less often than those without VI. This cross-sectional study compared participation rates in government-funded screening for breast, cervical and colorectal cancer in Canadians with and without VI, and examined associated sociodemographic factors.
Methods :
Self-reported data on vision status and participation in mammography, pap smear, and fecal occult blood test was analyzed from the Canadian Community Health Survey 2013/2014 and 2017/2018. Participation in screening at the recommended age and time interval was compared between individuals with and without VI. Screening rates were also compared by level of household income and education, and having a family physician.
Results :
Canadians with VI had lower participation rates in breast (53.0% [95% confidence interval [CI] 36.3-69.7%] vs. 67.0% [95% CI 64.5-69.4%]) and cervical (53.8% [95% CI 29.3-78.3%] vs. 76.2% [95% CI 74.0-78.3%]) cancer screening versus those without VI in 2013/2014. Colorectal cancer screening rates were similar for participants with and without VI (25.7% [95% CI 17.3-34.1%] vs. 24.7% [95% CI 23.7-25.6%]). Differences between the VI and non-VI groups across the three cancer screening categories persisted despite having a family physician. Lower levels of household income and education were associated with lower screening rates in the VI group for all cancer screenings examined. The 2017/2018 data similarly revealed a lower breast cancer (61.9% [95% CI 55.7-68.2%] vs. 69.4% [95% CI 66.3-72.5%]) and a comparable colorectal cancer screening rate (40.7% [95% CI 37.0-44.5%] vs. 38.0% [95% CI 36.4-39.5%]) in Canadians with versus without VI. Information on cervical cancer screening was unavailable in 2017/2018.
Conclusions :
Canadians with self-reported VI appear to have lower participation rates in breast and cervical cancer screening than those without VI. Having a family physician did not impact the noticed lower participation rate. Smaller sample sizes in individuals with VI are likely responsible for the wide CI and non-significant differences observed. Policy-makers, organizations and clinicians should understand the unique barriers faced by individuals with VI, and facilitate adherence to screening guidelines.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.