A medical record is a modest document. It does not argue and it does not complain. It notes what was done to a body, on what date, by whose hand. Read one at a time, such records say little. Read in their millions, they begin to show what was never done, and to whom.
On 5 October 2026 the journal JAMA Network Open published a study led by Diane Harper, professor of family medicine and of obstetrics and gynecology at the University of Michigan Medical School. Her team went through the medical records of 2.3 million American women who were between 20 and 60 years old in 2016, and followed those records through 2022 to see who had been tested for cervical cancer. Among them were 15,727 women with physical disabilities. They made up 0.7 percent of the whole.
Of the women with physical disabilities, 63.5% had been screened. Of the women without disabilities, 70.9% had. That is a gap of 7.4 percentage points. “It’s so striking,” Harper told CIDRAP News, which reported the findings. “They are, to be precise, 21% less likely to have cervical cancer screening than women without disabilities.”
Every column of the table
The researchers broke the women down by age, race, ethnicity and education, the usual measures for sorting who reaches a doctor and who does not. The disabled women fell behind every time. “What we found is that for every single category—by age, by race group, by ethnic group, and by whether or not they attended any kind of college—is that women with physical disabilities had significantly less cervical cancer screening than women without physical disabilities,” Harper said.
Here a reflection, and only that. When a difference survives every way of slicing a population, it starts to look less like a property of the women and more like a property of the place they are trying to get into. The clinic, after all, was designed with someone in mind.
What the women believed
Surveys had suggested the gap before. Past self-reported data pointed the same way, but Harper did not trust what people remember about their own examinations. “Women believe that if they’ve taken their underwear off, that means they’ve gotten a cervical cancer screen, which is not true,” she said. “We were really looking for a way to get a much more rigorous idea of what was happening.”
Records were that way. “This is the first project that’s been published that can actually look at women with physical disabilities in large numbers and look at it from the standpoint of sociodemographic [identities] that are associated with cervical cancer screening in the United States,” Harper told CIDRAP. Her research covers human papillomavirus vaccination, cervical cancer and disability, and the question she started from was a simple one: do disabled women get screened as often as everyone else?
The stirrups
The new paper counts. An earlier one from the same group listened. In January 2025 JAMA Network Open published a qualitative study, with Harper as corresponding author, in which 56 women with physical disabilities tried self-sampling kits at home between November 2021 and April 2023, then filled out a survey and were interviewed by phone.
According to the published paper, 49 of the 53 participants who had been through a speculum examination described it as a bad experience. They spoke of clinic equipment such as stirrups that they could not use, of clinicians’ ableism, of the sheer trouble of getting there. Some put off screening because of it. One woman skipped a recommended colposcopy out of “fear of having to go through that humiliation again.” All 56 called self-sampling comfortable and convenient, and 37 said it would make them likelier to be screened on time. The authors still added a caution: self-sampling “will not alleviate the lack of clinician training around disability health.”
That 2025 paper’s introduction stated that women with physical disabilities are 48% less likely to be screened than other women. The new figure, built from records, is 21%. They are different measurements, made by different methods, and the newer one is the smaller of the two. It is still a fifth less screening for a cancer that screening is meant to find early.
A shortage of numbers
Connie Lam, director of the NYU Langone Initiative for Women with Disabilities, who had no part in the research, told CIDRAP the paper fills a long-standing gap. “There’s not a lot of research around people with disabilities, in general, especially in gynecology care,” she said. “Educating the population, building awareness, having more statistics, this speaks for itself.”
Statistics are a cold form of attention, but even they had mostly not been paid. Apply the 63.5% to the 15,727 women and the remainder is roughly 5,700 women with no screening in their records over those years. Each one had a chart. Every chart had the same empty line.