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BHAWD Mission Statement - To increase the access of women with disabilities to breast health information, screenings and early breast cancer detection


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Increasing Breast Health Access for Women with Disabilities Co-principal Investigators: Mary Smith, Alta Bates Summit Foundation, Berkeley; and Carol N. D'Onofrio, Northern California Cancer Center, Union City

Abstract #: F-11 With the overall objective of increasing access to breast screening for women with disabilities, this 30-month project is addressing 5 key research questions: (1) What is the prevalence of barriers to breast screening among women with physical disabilities? (2) Are these barriers, differences in types and severity of functional limitation, and age and ethnicity associated with differences in screening utilization? (3) To what extent do the outreach, education, and service delivery strategies employed to date by the Breast Health Access for Women with Disabilities (BHAWD) coalition reduce barriers to screening? (4) What changes are needed in BHAWD strategies and in health policy to increase access to breast screening for women with disabilities? (5) What are the prospects for disseminating the BHAWD program to other California communities?

To study the first 2 questions and test related hypotheses, the project is analyzing data on disability and breast screening from the 1994 National Health Interview Survey (NHIS), the Health Promotion supplement, the Medical Access supplement, and the Disability Followback. Seven months were required to clarify NHIS sampling procedures, variable definitions, and the number of women age 20 and over who completed each component of the 1994 NHIS; however, these data sets have now been merged into a common file, new variables related to disabling conditions and functional limitations have been created, and analysis has been started. Findings to date have been used to draft a local telephone survey of women with disabilities that will provide more in-depth information about screening utilization and barriers, as well as data needed to address study questions 3 and 4. BHAWD partners have identified over 1,400 women eligible for the survey, Preparation of a manual evaluating BHAWD's work has begun, and leaders in the breast cancer and disability movements who wish to participate in later project phases continue to be identified.

Next steps will be (1) to complete analysis of the NHIS data, (2) to conduct the local survey, (3) to complete the draft BHAWD manual, and (4) to organize Task Forces to critically review it. In the final project year, the revised manual will be used to assess the generalizability of the BHAWD model and factors affecting its dissemination to other California communities. This project will reduce the human and economic impact of breast cancer for women with disabilities by filling an information void and by informing further research, policy initiatives, and program development.

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Blindness and Breast Cancer

WESTPORT, CT (Reuters Health) Mar 09 - Research conducted in Norway indicates that totally blind women are at decreased risk for breast cancer, especially those who became blind before age 65 years. "Our findings give support to the 'melatonin hypothesis'," the researchers say, which postulates that melatonin has a protective effect against breast cancer.

Dr. J. Kliukiene and colleagues, of the Cancer Registry of Norway, in Oslo, used data from the Norwegian Registry of Blindness to identify 15,412 visually impaired women. Of these, 396 were totally blind.

Based on follow-up beginning in 1961 or at the onset of blindness, the standardized incidence ratio for breast cancer was 0.64 in totally blind women. For those blinded before age 65, the incidence ratio was 0.51, the investigators report in the British Journal of Cancer for February 2.

There appeared to be no association between visual impairment short of total blindness and breast cancer, as illustrated by the standardized incidence ratio of 0.92 for those with moderate low vision and 1.21 for those with near-total blindness.

According to the authors, experimental evidence shows that increased nocturnal exposure to visible light reduces melatonin levels and is associated with increased growth of breast cancer. Blind women who are not ocularly receptive to light may maintain melatonin production at night regardless of light exposure. Dr. Kliukiene's team suggests that this is the mechanism whereby these women are protected from breast cancer.

Br J Cancer 2001;84:397-399.

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Maximizing Health in Menopausal Women with Disabilities appeared in the May-June 2002 edition of Menopause, the Journal of the North American Menopause Society, published by Lippincott Williams & Wilkins. A synopsis of the article can be viewed on the Lippincott web site at http://www.menopause.org/abstract/93208.html The full text of the article itself may be obtained from any medical library, or by writing to the publisher at Lippincott Williams & Wilkins, P.O. Box 1610, Hagerstown, MD 21740-1600, Telephone: 800/638-3030.

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Assessing barriers to breast cancer screening and treatment for women with disabilities

The purpose of this project is to learn about the barriers women with physical disabilities experience when they try to access breast cancer screening and treatment services. Researchers from the Centers for Disease Control and Prevention, the Center for Research on Women with Disabilities, and the RTC/IL conducted focus groups involving women with disabilities in seven cities across the country. Participants were divided into three groups: those who have accessed breast cancer screening services, those who have never accessed these services, and those who have undergone treatment for breast cancer. Results from these groups will be used to identify and better understand the barriers to these services, and to make screening and treatment facilities and programs more accessible in the future. For more information on this project contact Dot Nary, dotN@ku.edu

For additional information, please visit http://www.rtcil.org/whatwedo.htm

Click this image to return to the list of research items

Blindness and Breast Cancer

WESTPORT, CT (Reuters Health) Mar 09 - Research conducted in Norway indicates that totally blind women are at decreased risk for breast cancer, especially those who became blind before age 65 years. "Our findings give support to the 'melatonin hypothesis'," the researchers say, which postulates that melatonin has a protective effect against breast cancer.

Dr. J. Kliukiene and colleagues, of the Cancer Registry of Norway, in Oslo, used data from the Norwegian Registry of Blindness to identify 15,412 visually impaired women. Of these, 396 were totally blind.

Based on follow-up beginning in 1961 or at the onset of blindness, the standardized incidence ratio for breast cancer was 0.64 in totally blind women. For those blinded before age 65, the incidence ratio was 0.51, the investigators report in the British Journal of Cancer for February 2.

There appeared to be no association between visual impairment short of total blindness and breast cancer, as illustrated by the standardized incidence ratio of 0.92 for those with moderate low vision and 1.21 for those with near-total blindness.

According to the authors, experimental evidence shows that increased nocturnal exposure to visible light reduces melatonin levels and is associated with increased growth of breast cancer. Blind women who are not ocularly receptive to light may maintain melatonin production at night regardless of light exposure. Dr. Kliukiene's team suggests that this is the mechanism whereby these women are protected from breast cancer.

Br J Cancer 2001;84:397-399.


HOME | VISION | NEWS | SERVICES & PROGRAMS | TOOLS & LINKS | RESEARCH | FAQ | DONOR INFO | VOLUNTEER | PUBLIC POLICY | BHAWD Order Form | CONTACT US | SITE MAP |