{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T21:01:24Z","timestamp":1788642084462,"version":"build-2803163510"},"reference-count":77,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T00:00:00Z","timestamp":1717286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"King Salman Center for Disability Research","award":["KSRG-000-000"],"award-info":[{"award-number":["KSRG-000-000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Breast cancer (BC) is one of the leading causes of mortality worldwide. There are observed disparities in patients with disability as compared to those without disability, which leads to poor BC screening attendance, thereby worsening disease management. Aim: The aim of this systematic review is to investigate if there are disparities in screening rates in women with disability as compared to those without disability, as well as the different factors that pose barriers to patients with disability for enrolment in BC screening programs. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed published articles between 2008 and 2023, which assessed different factors that contributed to poor attendance in BC screening programs held across different countries. Detailed study characteristics were obtained, and methodological quality assessment was performed on the individual studies included in this review. Result: A total of fifty-three articles were identified as eligible studies based on the pre-defined inclusion and exclusion criteria. These included 7,252,913 patients diagnosed with BC (913,902 patients with disability\/6,339,011 patients without disability). The results revealed there are demographic, clinical, financial, and service-related barriers that contributed to lower screening rates in disabled patients as compared to non-disabled. Patient age is the most common factor, with the highest effect observed for 80 years (vs. 30\u201344 years) [odds ratio (OR) = 13.93 (95% confidence interval (CI) = 8.27\u201323.47), p &lt; 0.0001], followed by race\/ethnicity for Hispanic (vs. non-Hispanic white) [OR = 9.5 (95%CI = 1.0\u201391.9), p &lt; 0.05]. Additionally, patients with multiple disabilities had the highest rate of dropouts [OR = 27.4 (95%CI = 21.5\u201333.3)]. Other factors like education, income, marital status, and insurance coverage were essential barriers in screening programs. Conclusions: This study presents a holistic view of all barriers to poor BC screening attendance in disabled patients, thereby exacerbating health inequalities. A standardized approach to overcome the identified barriers and the need for a tailored guideline, especially for disability groups, is inevitable.<\/jats:p>","DOI":"10.3390\/jcm13113283","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T05:58:00Z","timestamp":1717394280000},"page":"3283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A Systematic Review to Evaluate the Barriers to Breast Cancer Screening in Women with Disability"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2747-608X","authenticated-orcid":false,"given":"Huda I.","family":"Almohammed","sequence":"first","affiliation":[{"name":"Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3322\/caac.21262","article-title":"Global cancer statistics, 2012","volume":"65","author":"Torre","year":"2015","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"215","DOI":"10.7326\/M15-1536","article-title":"Collaborative modeling of the benefits and harms associated with different US breast cancer screening strategies","volume":"164","author":"Mandelblatt","year":"2016","journal-title":"Ann. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1158\/1055-9965.EPI-14-1286","article-title":"The contribution of mammography screening to breast cancer incidence trends in the United States: An updated age\u2013period\u2013cohort model","volume":"24","author":"Gangnon","year":"2015","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"244","DOI":"10.7326\/M15-0969","article-title":"Effectiveness of breast cancer screening: Systematic review and meta-analysis to update the 2009 US Preventive Services Task Force recommendation","volume":"164","author":"Nelson","year":"2016","journal-title":"Ann. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-12-99","article-title":"Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: A cross-sectional study","volume":"12","author":"Damiani","year":"2012","journal-title":"BMC Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"100485","DOI":"10.1016\/j.srhc.2020.100485","article-title":"Barriers to reproductive health services for women with disability in low-and middle-income countries: A review of the literature","volume":"24","author":"Casebolt","year":"2020","journal-title":"Sex. Reprod. Healthc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"102084","DOI":"10.1016\/j.canep.2021.102084","article-title":"A systematic review of the barriers and facilitators influencing the cancer screening behaviour among people with intellectual disabilities","volume":"76","author":"Chan","year":"2022","journal-title":"Cancer Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Inchai, P., Tsai, W.C., Chiu, L.T., and Kung, P.T. (2022). Inequality in the utilization of breast cancer screening between women with and without disabilities in Taiwan: A propensity-score-matched nationwide cohort study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095280"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1177\/0969141319888553","article-title":"Disability as a predictor of breast cancer screening uptake: A population-based study of 57,328 women","volume":"27","author":"Ross","year":"2020","journal-title":"J. Med. Screen."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1038\/bjc.2017.331","article-title":"Disability and participation in breast and bowel cancer screening in England: A large prospective study","volume":"117","author":"Floud","year":"2017","journal-title":"Br. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E09","DOI":"10.5888\/pcd14.160312","article-title":"Peer reviewed: Prevalence of cancer screening among adults with disabilities, United States, 2013","volume":"14","author":"Steele","year":"2017","journal-title":"Prev. Chronic Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.respe.2015.11.009","article-title":"Access to care and prevention for people with disabilities in France: Analysis based on data from the 2008 French health and disabilities households surveys (Handicap-Sante-Menages)","volume":"64","author":"Pichetti","year":"2016","journal-title":"Rev. Epidemiol. Sante. Publique."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.jacr.2019.02.044","article-title":"Beyond universal health care: Barriers to breast cancer screening participation in Canada","volume":"16","author":"Zha","year":"2019","journal-title":"J. Am. Coll. Radiol."},{"key":"ref_14","unstructured":"(2024, April 09). Centers of Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/ncbddd\/disabilityandhealth\/righttoknow\/overview.html#:~:text=What%20Is%20The%20Right%20To,have%20ever%20received%20a%20mammogram."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/jocn.12696","article-title":"Barriers to breast cancer screening in Australia: Experiences of women with physical disabilities","volume":"24","author":"Peters","year":"2015","journal-title":"J. Clin. Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1093\/jbi\/wbad106","article-title":"Optimizing the Patient Experience for Women With Disabilities in the Breast Imaging Clinic","volume":"6","author":"Net","year":"2024","journal-title":"J. Breast Imaging"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/19371918.2015.1137509","article-title":"Identifying barriers and facilitators to breast health services among women with disabilities","volume":"31","year":"2016","journal-title":"Soc. Work Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1001\/jamasurg.2021.0522","article-title":"MOOSE reporting guidelines for meta-analyses of observational studies","volume":"156","author":"Brooke","year":"2021","journal-title":"JAMA Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.physio.2009.07.001","article-title":"Medline","volume":"95","author":"Harms","year":"2009","journal-title":"Physiotherapy"},{"key":"ref_21","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2000, July 05). The Newcastle-Ottawa Scale (NOS) For Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available online: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1352\/1934-9556-50.2.79","article-title":"Cervical and breast cancer\u2013screening knowledge of women with developmental disabilities","volume":"50","author":"Parish","year":"2012","journal-title":"Intellect. Dev. Disabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1158\/1055-9965.EPI-21-0152","article-title":"Function-related indicators and outcomes of screening mammography in older women: Evidence from the Breast Cancer Surveillance Consortium Cohort","volume":"30","author":"Zhang","year":"2021","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/jir.12336","article-title":"Breast cancer and screening in persons with an intellectual disability living in institutions in France","volume":"61","author":"Bourgarel","year":"2017","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1007\/s11606-019-05182-5","article-title":"Benefits and harms of mammography screening for women with Down syndrome: A collaborative modeling study","volume":"34","author":"Alagoz","year":"2019","journal-title":"J. Gen. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1080\/10790268.2016.1153293","article-title":"Adherence to US Preventive Services Task Force recommendations for breast and cervical cancer screening for women who have a spinal cord injury","volume":"40","author":"Xu","year":"2017","journal-title":"J. Spinal Cord Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1177\/1049731511415550","article-title":"Cancer screening knowledge changes: Results from a randomized control trial of women with developmental disabilities","volume":"22","author":"Parish","year":"2012","journal-title":"Res. Soc. Work. Pract."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s12032-010-9656-3","article-title":"Predictors of mammography use in older women with disability: The patients\u2019 perspectives","volume":"28","author":"Caban","year":"2011","journal-title":"Med. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e2248980","DOI":"10.1001\/jamanetworkopen.2022.48980","article-title":"Breast cancer screening among women with intellectual disability in Denmark","volume":"6","author":"Michelsen","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Andiwijaya, F.R., Davey, C., Bessame, K., Ndong, A., and Kuper, H. (2022). Disability and participation in breast and cervical cancer screening: A systematic review and meta-analysis. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19159465"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1108\/TLDR-07-2014-0024","article-title":"Access to cancer screening by people with learning disabilities in England 2012\/13: Information from the Joint Health and Social Care Assessment Framework","volume":"19","author":"Glover","year":"2014","journal-title":"Tizard Learn. Disabil. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1352\/1944-7558-188.4.327","article-title":"Accuracy of self-reported cervical and breast cancer screening by women with intellectual disability","volume":"118","author":"Son","year":"2013","journal-title":"Am. J. Intellect. Dev. Disabil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"142","DOI":"10.7224\/1537-2073-14.3.142","article-title":"Relationship between expanded health belief model variables and mammography screening adherence in women with multiple sclerosis: A pilot study","volume":"14","author":"Paraska","year":"2012","journal-title":"Int. J. MS Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/MLR.0000000000001449","article-title":"Associations between disability and breast or cervical cancers, accounting for screening disparities","volume":"59","author":"Iezzoni","year":"2021","journal-title":"Med. Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1352\/1934-9556-57.3.177","article-title":"Racial\/ethnic disparities in mammogram frequency among women with intellectual disability","volume":"57","author":"Arana","year":"2019","journal-title":"Intellect. Dev. Disabil."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/j.whi.2013.10.009","article-title":"Breast and cervical cancer screening disparities associated with disability severity","volume":"24","author":"Dobbertin","year":"2014","journal-title":"Women's Health Issues"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.dhjo.2014.06.004","article-title":"Barriers to cancer screening for people with disabilities: A literature review","volume":"8","author":"Merten","year":"2015","journal-title":"Disabil. Health J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1093\/jnci\/djad130","article-title":"Disparities in breast cancer among patients with disabilities: Care gaps, accessibility, and best practices","volume":"115","author":"Keegan","year":"2023","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1038\/sj.bjc.6604203","article-title":"Breast cancer mortality with varying invitational policies in organised mammography","volume":"98","author":"Sarkeala","year":"2008","journal-title":"Br. J. Cancer"},{"key":"ref_40","unstructured":"Government of the Republic of Korea (2024, April 09). Act on the Prohibition of Discrimination Against Disabled Persons, Remedy Against Infringement of their Rights (Korean Law). Available online: https:\/\/www.un.org\/development\/desa\/disabilities\/wp-content\/uploads\/sites\/15\/2019\/11\/Korea-Republic-of_Act-on-the-Prohibition-of-Discrimination-of-Disabled-Persons-Remedy-Against-Infringement-of-their-Rights-etc.pdf."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1089\/jwh.2014.5181","article-title":"Trends in mammography over time for women with and without chronic disability","volume":"24","author":"Iezzoni","year":"2015","journal-title":"J. Women's Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1002\/RNJ.00013","article-title":"Breast cancer screening barriers and disability","volume":"37","author":"Todd","year":"2012","journal-title":"Rehabil. Nurs. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"699108","DOI":"10.3389\/fpubh.2021.699108","article-title":"Socioeconomic Determinants of Participation in Cancer Screening in Argentina: A Cross-Sectional Study","volume":"9","author":"Sakellariou","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1002\/cncr.32693","article-title":"Breast cancer screening disparities between women with and without disabilities: A national database study in South Korea","volume":"126","author":"Shin","year":"2020","journal-title":"Cancer"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"100873","DOI":"10.1016\/j.dhjo.2019.100873","article-title":"Health disparities among breast cancer patients with\/without disabilities in Germany","volume":"13","author":"Pfaff","year":"2020","journal-title":"Disabil. Health J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.dhjo.2018.02.002","article-title":"Breast cancer screening in women with cerebral palsy: Could care delivery be improved?","volume":"11","author":"Nandam","year":"2018","journal-title":"Disabil. Health J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/pcn.12554","article-title":"Cancer screening participation in schizophrenic outpatients and the influence of their functional disability on the screening rate: A cross-sectional study in Japan","volume":"71","author":"Fujiwara","year":"2017","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.ypmed.2017.04.034","article-title":"A longitudinal assessment of adherence to breast and cervical cancer screening recommendations among women with and without intellectual disability","volume":"100","author":"Xu","year":"2017","journal-title":"Prev. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ridd.2014.10.052","article-title":"Mammography usage with relevant factors among women with mental disabilities in Taiwan: A nationwide population-based study","volume":"37","author":"Yen","year":"2015","journal-title":"Res. Dev. Disabil."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Bussi\u00e8re, C., Sicsic, J., and Pelletier-Fleury, N. (2014). The effects of obesity and mobility disability in access to breast and cervical cancer screening in france: Results from the national health and disability survey. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0104901"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.ypmed.2014.07.025","article-title":"Level of disability, multi-morbidity and breast cancer screening: Does severity matter?","volume":"67","author":"Guilcher","year":"2014","journal-title":"Prev. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1111\/jir.12062","article-title":"Test of an intervention to improve knowledge of women with intellectual disabilities about cervical and breast cancer screening","volume":"58","author":"Swaine","year":"2014","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/jir.12035","article-title":"Are cervical and breast cancer screening programmes equitable? The case of women with intellectual and developmental disabilities","volume":"57","author":"Cobigo","year":"2013","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.dhjo.2012.08.004","article-title":"Receipt of mammography among women with intellectual disabilities: Medical record data indicate substantial disparities for African American women","volume":"6","author":"Parish","year":"2013","journal-title":"Disabil. Health J."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Osborn, D.P., Horsfall, L., Hassiotis, A., Petersen, I., Walters, K., and Nazareth, I. (2012). Access to cancer screening in people with learning disabilities in the UK: Cohort study in the health improvement network, a primary care research database. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0043841"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1002\/cncr.26393","article-title":"Does a standard measure of self-reported physical disability correlate with clinician perception of impairment related to cancer screening?","volume":"118","author":"Buckley","year":"2012","journal-title":"Cancer"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"001.04.a02","DOI":"10.5600\/mmrr.001.04.A02","article-title":"Disparities in routine breast cancer screening for Medicaid managed care members with a work-limiting disability","volume":"1","author":"Weir","year":"2011","journal-title":"Medicare Medicaid Res. Rev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ridd.2011.08.032","article-title":"The assessment of the likelihood of mammography usage with relevant factors among women with disabilities","volume":"33","author":"Kung","year":"2012","journal-title":"Res. Dev. Disabil."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"693","DOI":"10.3122\/jabfm.2011.06.110095","article-title":"Determinants of mammography in women with intellectual disabilities","volume":"24","author":"Wilkinson","year":"2011","journal-title":"J. Am. Board. Fam. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1089\/jwh.2010.2609","article-title":"Factors associated with self-reported mammography use for women with and women without a disability","volume":"20","author":"Armour","year":"2011","journal-title":"J. Women\u2019s Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"49","DOI":"10.7224\/1537-2073-13.2.49","article-title":"Barriers and Facilitators to Breast Cancer Screening: A Qualitative Study of Women with Multiple Sclerosis","volume":"13","author":"Todd","year":"2011","journal-title":"Int. J. MS Care"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.whi.2009.08.001","article-title":"Repeat mammography screening among unmarried women with and without a disability","volume":"19","author":"Clark","year":"2009","journal-title":"Womens Health Issues"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1177\/0969141319860873","article-title":"Measuring height and weight as part of routine mammographic screening for breast cancer","volume":"26","author":"Darcey","year":"2019","journal-title":"J. Med. Screen."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e024571","DOI":"10.1136\/bmjopen-2018-024571","article-title":"Utilisation of mammography by women with mobility impairment in the UK: Secondary analysis of cross-sectional data","volume":"9","author":"Sakellariou","year":"2019","journal-title":"BMJ Open"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1352\/1944-7558-123.6.499","article-title":"The Association Between Continuity of Primary Care and Preventive Cancer Screening in Women With Intellectual Disability","volume":"123","author":"Plourde","year":"2018","journal-title":"Am. J. Intellect. Dev. Disabil."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Sakellariou, D., and Rotarou, E.S. (2017). Utilisation of cancer screening services by disabled women in Chile. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0176270"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"947","DOI":"10.2105\/AJPH.2008.150318","article-title":"Barriers to adherence to screening mammography among women with disabilities","volume":"100","author":"Yankaskas","year":"2010","journal-title":"Am. J. Public Health"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/bld.12225","article-title":"Exploring breast cancer and screening awareness among Irish women with intellectual disabilities","volume":"46","author":"Reidy","year":"2018","journal-title":"Br. J. Learn. Disabil."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/s41416-023-02249-3","article-title":"Inequalities in cancer screening participation between adults with and without severe mental illness: Results from a cross-sectional analysis of primary care data on English Screening Programmes","volume":"129","author":"Kerrison","year":"2023","journal-title":"Br. J. Cancer"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1080\/09638288.2020.1817158","article-title":"Access to and engagement with cervical and breast screening services for women with disabilities in Aotearoa New Zealand","volume":"44","author":"Pearson","year":"2022","journal-title":"Disabil. Rehabil."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Yang, S., Bian, J., George, T.J., Daily, K., Zhang, D., Braithwaite, D., and Guo, Y. (2021). The association between cognitive impairment and breast and colorectal cancer screening utilization. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08321-6"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1176\/appi.ps.201900299","article-title":"Association Between the Maryland Medicaid Behavioral Health Home Program and Cancer Screening in People With Serious Mental Illness","volume":"71","author":"Murphy","year":"2020","journal-title":"Psychiatr Serv."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.amepre.2019.04.017","article-title":"Deaf Women's Health: Adherence to Breast and Cervical Cancer Screening Recommendations","volume":"57","author":"Kushalnagar","year":"2019","journal-title":"Am. J. Prev. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/09286586.2016.1213302","article-title":"Women with Visual Impairment and Insured by Medicaid or Medicare Are Less Likely to Receive Recommended Screening for Breast and Cervical Cancers","volume":"24","author":"Xu","year":"2017","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.whi.2015.02.004","article-title":"Disparities in receipt of breast and cervical cancer screening for rural women age 18 to 64 with disabilities","volume":"25","author":"Dobbertin","year":"2015","journal-title":"Women\u2019s Health Issues"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1007\/s00038-012-0395-4","article-title":"Inequalities in the use of mammography in Spain: Effect of caring for disabled family","volume":"57","author":"Sopacua","year":"2012","journal-title":"Int. J. Public Health"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1089\/jwh.2007.0591","article-title":"Breast and cervical cancer screening practices among disabled women aged 40\u201375: Does quality of the experience matter?","volume":"17","author":"Liu","year":"2008","journal-title":"J. Women\u2019s Health"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3283\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:52:37Z","timestamp":1760107957000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,2]]},"references-count":77,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13113283"],"URL":"https:\/\/doi.org\/10.3390\/jcm13113283","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,2]]}}}