Investigators have found a higher rate of mortality among patients with intellectual and developmental disabilities diagnosed with breast cancer, colorectal cancer, or lung cancer, according to a recent study published by Hansford et al in the Canadian Journal of Public Health.
Study Methods and Results
In this study, the investigators examined the outcomes of 340,000 patients diagnosed with breast cancer, colorectal cancer, or lung cancer in Ontario, Canada, between 2007 and 2019.
Compared with those who did not have intellectual and developmental disabilities, the investigators found the patients with these disabilities experienced 5-year survival rates of 61.5% vs 81.7% for breast cancer, 34.2% vs 56.6% for colorectal cancer, and 11.9% vs 19.7% for lung cancer. The patients with intellectual and developmental disabilities were 2.74, 2.42, and 1.49 times more likely to die of breast cancer, colorectal cancer, and lung cancer, respectively. Further, the patients with intellectual and developmental disabilities experienced worse survival outcomes regardless of their cancer stage at diagnosis.
Conclusions
The investigators hypothesized that implicit and explicit biases as well as ableism within medicine and nursing may have contributed to the inequitable health outcomes in this patient population.
“Physicians often believe [patients] with [intellectual and developmental disabilities] aren’t going to live as long, so it isn’t worth screening them for cancer. This is an antiquated way of thinking,” emphasized Craig Escudé, MD, FAAFP, FAADM, President of IntellectAbility. “Studies have shown that health-care [professionals] are often under the impression that [these patients] have a lower quality of life, [b]ut it’s important to recognize that just because somebody's life is different doesn’t mean it’s of a lower quality. We must value all [patients] and invest time and energy to help them live fuller and healthier lives,” he added.
The investigators indicated that misconceptions about quality of life and gaps in physician knowledge may be directly linked to a lack of training in how to appropriately care for patients with intellectual and developmental disabilities. It can often be challenging for health-care professionals to diagnose cancer in patients who are unable to verbally communicate their symptoms. Limitations in recognizing early signs of health destabilization in any population subgroup may lead to delayed or improper diagnoses and poorer health outcomes.
“It’s so important that we train clinicians to be able to look for other signs of early health destabilization. If we can catch these things earlier by increasing screenings and being more attuned to the different ways that a [patient] might present with signs or symptoms of an illness, we’re much more likely to produce better health outcomes,” concluded Dr. Escudé.
Disclosure: For full disclosures of the study authors, visit link.springer.com.
