Abstract
BackgroundThe World Health Organization has recognized that people with disability are among the most marginalized in the world. This study’s objective was to investigate the differences in the probability of colorectal cancer (CRC) screening with faecal immunochemical testing (FIT) between people with disability and without disability in Taiwan.MethodsThe study participants included people with and without disability from the Disability Registration Database (2012) and the National Health Insurance Research Database (2009–2012). The study included 50- to 69-year-olds with and without disability who were screened from 2011 to 2012 and were alive in 2012. There were 16 categories of disability. After propensity score matching (PSM) between the two groups, conditional logistic regression analysis with control variables was used to investigate the odds ratio (OR) that people with or without disability would undergo CRC screening.ResultsThe percentage of people with disability receiving CRC screening was 21.84%, and the highest rate of those receiving CRC screening (38.72%) was found in people with intractable epilepsy, whose OR was 1.47 times that of people with moving functional limitation (95% confidence interval (CI) = 1.17–1.85). The results showed that the probability of CRC screening in people with disability was lower than that in people without disability (OR = 0.88, 95%CI = 0.87–0.89). The probability of receiving CRC screening differed between people with different categories of disability.ConclusionsAlthough the probability of CRC screening in the four categories of disability was higher than that in the general population, overall, people with disability were less likely than people without disability to undergo CRC screening. Health inequalities still exist under National Health Insurance in Taiwan.
Highlights
The World Health Organization has recognized that people with disability are among the most marginalized in the world
The results showed that the number of people with disability who underwent colorectal cancer (CRC) screening (65,329, 21.84%) was lower than that of people with disability who did not receive CRC screening (233,778, 78.16%)
Among the categories of disability, the percentage of people receiving CRC screening was highest among people with intractable epilepsy (139 patients, 38.72%) and lowest among people with dementia (450 patients, 11.86%)
Summary
The World Health Organization has recognized that people with disability are among the most marginalized in the world. This study’s objective was to investigate the differences in the probability of colorectal cancer (CRC) screening with faecal immunochemical testing (FIT) between people with disability and without disability in Taiwan. A World Health Organization (WHO) survey in 2010 showed that the number of people with disability exceeds one billion globally (approximately 15.6–19.4% of the global population) and has been increasing in recent years [1]. Another study using public data from the National Health Interview Survey showed that people with disability were less likely to undergo CRC screening in 1998, but there was no difference in 2010 [5]. In Taiwan, there are no articles on CRC screening among people with disability
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