Imaging providers need to do a better job of reaching disabled adults, according to Mizzou study

 - Colonoscopy

Adults with disabilities undergo colon cancer screening at a lower rate when compared to the general population, according to a study published in the American Journal of Preventative Medicine. According to the authors, the findings represent an opportunity for care providers to ensure facilities are up to snuff and an impetus to reach out to group homes and other caregivers of disabled adults.

Previous studies have found adults with disabilities utilize less preventative care in general, but colorectal cancer screening is especially troublesome: it’s an easily treatable disease with an intensive exam—which can create additional barriers to care. The recent uptick in colon cancer in young Americans underscores the need for widespread screening, requiring both education on and access to preventative care.

Researchers from the University of Missouri School of Medicine examined data from South Carolina Medicaid and Medicare claims, state health plan claims and hospitals discharges from 2000 to 2009. They found 48 percent of the general public reported receiving regular colorectal cancer screenings, compared to 34 percent of people with intellectual disabilities (IDs), 44 percent of individuals with spinal cord injuries (SCIs) and 46 percent of people with blindness or low vision.

Barriers for individuals with IDs can include anxiety, lack of understanding of the test, transportation problems or the need for extra staff to accompany them to an appointment, according to a review published in the Journal of the American Board of Family Medicine. In addition, constipation is a common problem for intellectually disabled adults living in group homes, making it difficult to identify certain colon cancer symptoms.

Patients with spinal cord injuries often report accessibility barriers in examinations rooms, regardless of practice type. Lack of caregiver expertise also contributes to their depressed rate of colorectal cancer screening, according to a survey of SCI patients, published in the Archives of Physical Medicine and Rehabilitation.

“More than one third of all respondents aged ≥50 years had not received a screening colonoscopy. Inability to prepare for the test was the most frequently reported reason (71.4%) followed by lack of a physician recommendation,” wrote Williams et al . “One participant noted that although he was due for a colonoscopy, neither he nor his doctor ‘knew how to deal with the prep…so had decided to wait another five years.’”

University of Missouri researchers recommended clinics conduct Americans with Disabilities Act self-assessments and ensure their clinical staff are properly trained in assisting individuals with mobility disabilities.

Individuals with blindness utilized screening at a rate just under the normal population, possibly attributed to their inability to notice onset symptoms of colon cancer such as blood in stool, according to a study published in the Journal of Clinical Outcomes Management.  

While there’s plenty of advocacy to increase colorectal screening across the board, boosting rates for disabled adults will take a more targeted approach, according to the authors.

“These individuals may not be routinely screened for colorectal cancer due to a lack of education and awareness, transportation challenges or other barriers,” lead author Chelsea Deroche, PhD, assistant professor of biostatistics at the University of Missouri, said in a statement. “These findings support the need for increased awareness and targeted advocacy outreach efforts to both physicians and caregivers to ensure all individuals are screened appropriately.”