Optimising access for women with disabilities to mammography screening

Poulos, A., Balandin, S., Llewellyn, G., & Dew, A., (2006). Women with cerebral palsy and breast cancer screening by mammography. Archives of Physical Medicine and Rehabilitation, 87, 304-07

Poulos, A. & Llewellyn, G. (2005). Mammography discomfort: a holistic perspective derived from women's experiences. Radiography, 11(1) 17-25.

Project team

Prof Gwynnyth Llewellyn
Prof Susan Balandin
Dr Ann Poulos
Dr Louella McCarthy
Leigha Dark


This study, funded by the National Breast Cancer Foundation, Kathleen Cuningham Research Grant (2005-2008), brought an innovative multidisciplinary perspective to the challenge of overcoming the barriers to mammography screening experienced by Australian women with disabilities.

BreastScreen NSW endorsed this research project and cooperated with the researchers to ensure the service was widely accessible


Blending the methodological insights from the health and social sciences with oral history, the study aimed to determine the nature of the barriers for women with disabilities participating in mammography screening and to design strategies for overcoming them.


Phase 1: Determining women’s experiences of mammography screening

In the first phase the project conducted in-depth interviews to understand the breast screening experiences of women with disabilities. Seventy-five women, aged between 50-69yrs were interviewed. Themes addressed in the interviews included the nature of physical barriers produced by the built environment; the impact of having complex or different communication needs; women’s familial and social networks and how these influenced health care; education, employment and residential histories; and interactions with and attitudes to health care providers.

Phase 2: Radiographic staff responses to the women’s data

Barriers to and facilitators of participation raised by the women were presented to radiography and administrative staff from BreastScreen NSW who were bought together in six focus groups. In these focus groups, radiographers were given the opportunity to explore their own experience of these issues; to share difficulties encountered and solutions devised in a collegial and professional setting.

Phase 3: In situ analyses of the screening environment

The third phase was the point at which the ideas and solutions proposed by the first two phases were assessed. Using in situ analysis, women from Phase 1 were invited to attend an individualised mammographic screening session through BreastScreen NSW. Each participant was accompanied by qualified research team member in order to analyse the nature and extent of the barriers in the screening environment.


  1. Support for the widespread implementation of the Decision Tool among GPs and disability support services.
  2. Appointment of an Advisory Committee of women with disabilities.
  3. Accessibility audit of all screening units, including parking, toilets and external access ways.
  4. The production of accessible informational and promotional material relevant for all women with disabilities.
  5. Inclusion of “disability accessibility and awareness” as a category for assessment in the accreditation guidelines.
  6. Establishment of a Disability complaint/info line.
  7. At least one wheelchair accessible mammography machine in each screening service.
  8. At least one staff member disability awareness training in each screening unit.
  9. Including women with disabilities in curriculum development.
  10. Appointment of a Disability Advisory Officer to provide tailored training for all staff and advice on a service-wide basis.

Related Links

BreastScreen NSW.
BreastScreen NSW is a free breast screening service for women aged 50–69 years. This government funded service aims to detect breast cancer in its early stages, when treatment can be most effective. BreastScreen NSW has a network of local services across NSW including 37 regional centres and 13 screening vans which continually tour and service remote areas and specific communities within NSW

National Breast Cancer Foundation.
In partnership with the Australian community the National Breast Cancer Foundation is leading the pursuit for new knowledge in the prevention, diagnosis and treatment of breast cancer.

Women With Disabilities Australia (WWDA).
WWDA is a national voice for the needs and rights of women with disabilities and a national force to improve the lives and life chances of women with disabilities.

Related Publications

Balandin, S. & Morgan, J. (1997). Adults with cerebral palsy: What's happening? Journal of Intellectual & Developmental Disability, 22(2), 09-124.

Balandin, S., Dew, A., Llewellyn, G., & Kendig, H. (2003). Health care experiences of people with cerebral palsy and complex communication needs. AGOSCI Something to Say, Sydney, AGOSCI.

Llewellyn, G., McConnell, D., & Mayes, R. (2003). Health of mothers with intellectual limitations. Australian and New Zealand Journal of Public Health, 27, 17-19.

Llewellyn, G., Balandin, S., Poulos, A., & Dew, A. 2003. Pilot survey of the 10 BreastScreen NSW Screening and Assessment Centres. Unpublished paper, available from Professor Gwynnyth Llewellyn, Faculty of Health Sciences, University of Sydney, Sydney.

Moreira, C., Svoboda, K., Poulos, A., Taylor, R. Page, A., & Rickard, M. (2005). Comparison of the validity and reliability of two image classification systems for the assessment of mammogram quality. Journal of Medical Screening, 12(1), 38-42.

Poulos, A. & Llewellyn, G. (2005). Mammography discomfort: a holistic perspective derived from women's experiences. Radiography, 11(1), 17-25.