Sophie E Groß1, Holger Pfaff2, Michael Swora3, Lena Ansmann4, Ute-Susann Albert5, Anke Groß-Kunkel6. 1. Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933, Cologne, Germany; Rhineland State Council - Institute of Health Care Research - LVR-IVF, Cologne, Germany, Wilhem-Griesinger Str. 23, 51109, Cologne, Germany. Electronic address: sophie.gross@lvr.de. 2. Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933, Cologne, Germany. Electronic address: Holger.Pfaff@uk-koeln.de. 3. Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933, Cologne, Germany. Electronic address: MIchael.Swora@uk-koeln.de. 4. Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933, Cologne, Germany; Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Ammerlaender Heerstrasse 140, 26129, Oldenburg, Germany. Electronic address: lena.ansmann@uni-oldenburg.de. 5. Department of Gynecology and Obstetrics, Head of Senology and Conservative Gyneco-Oncology, Klinikum Kassel GmbH, Mönchebergstr. 41-43, 34125, Kassel, Germany; C/o AWMF-Institute for Medical Knowledge Management, Faculty of Medicine, Germany, Philipps-University, Karl-von-Frisch-Str.1, 35043, Marburg, Germany. Electronic address: albertu@staff.uni-marburg.de. 6. Department of Special Education and Rehabilitation, Faculty of Human Sciences, University of Cologne, Germany, Klosterstrasse 79b, 50931, Cologne, Germany. Electronic address: anke.gross@uni-koeln.de.
Abstract
BACKGROUND: Prevalence and incidence of cancer are increasing in people with disability. Nevertheless, little is known about cancer care for people with disabilities. OBJECTIVE: The goal of this study was to examine the quality of care of breast cancer patients with pre-existing disabilities regarding diagnosis and type of breast surgery in Germany. METHODS: Within the framework of quality assurance of breast cancer centers, a patient survey was conducted by the University of Cologne. Survey data from 4626 newly-diagnosed breast cancer patients treated in 86 hospitals were analyzed using multilevel modeling. Data about socio-demographics, disability specific data as well as data about diagnosis and type of surgery were collected. RESULTS: About 13% (n = 568) of the patients indicated they had a pre-existing disability prior to their breast cancer. The majority of patients with disabilities have physical impairments (PI n = 385; 68.0%) or sensory impairments (SI n = 131; 23.1%). 16.7% of the patients indicated they have a mental illness (MI n = 95; 16.7%) and 8 patients indicated to have an intellectual disability (ID n = 8; 1.4%). Patients with PI and SI are less often diagnosed for cancer through a mammography screening (OR PI = 0.70; p < 0.05; OR SI = 0.58; p < 0.05). Patients with PI are less likely to receive breast conserving treatment (OR = 0.58; p < 0.00) and more likely to have a mastectomy without reconstruction (OR = 1.96; p < 0.00) compared to patients without disabilities. CONCLUSION: Our data show that there are differences in the frequency of cancer diagnosis through mammography screening and in surgery applied between breast cancer patients with and without disabilities.
BACKGROUND: Prevalence and incidence of cancer are increasing in people with disability. Nevertheless, little is known about cancer care for people with disabilities. OBJECTIVE: The goal of this study was to examine the quality of care of breast cancerpatients with pre-existing disabilities regarding diagnosis and type of breast surgery in Germany. METHODS: Within the framework of quality assurance of breast cancer centers, a patient survey was conducted by the University of Cologne. Survey data from 4626 newly-diagnosed breast cancerpatients treated in 86 hospitals were analyzed using multilevel modeling. Data about socio-demographics, disability specific data as well as data about diagnosis and type of surgery were collected. RESULTS: About 13% (n = 568) of the patients indicated they had a pre-existing disability prior to their breast cancer. The majority of patients with disabilities have physical impairments (PI n = 385; 68.0%) or sensory impairments (SI n = 131; 23.1%). 16.7% of the patients indicated they have a mental illness (MI n = 95; 16.7%) and 8 patients indicated to have an intellectual disability (ID n = 8; 1.4%). Patients with PI and SI are less often diagnosed for cancer through a mammography screening (OR PI = 0.70; p < 0.05; OR SI = 0.58; p < 0.05). Patients with PI are less likely to receive breast conserving treatment (OR = 0.58; p < 0.00) and more likely to have a mastectomy without reconstruction (OR = 1.96; p < 0.00) compared to patients without disabilities. CONCLUSION: Our data show that there are differences in the frequency of cancer diagnosis through mammography screening and in surgery applied between breast cancerpatients with and without disabilities.