Investigators have found that adults with learning disabilities may be more likely to die from cancer compared with those in the general population, according to a recent study published by Ward et al in BMJ Open.
Background
Many cancers are considered either preventable or treatable. However, until now there has been a lack of comparable evidence assessing the differences in cancer incidence and mortality between those with and without learning disabilities.
Individuals with learning disabilities continue to face significant health inequalities, including a 20-year mortality gap and a higher proportion of avoidable deaths compared with those in the general population.
The evidence highlights a clear need to increase awareness of cancer symptoms among adults with learning disabilities, their families, and carers—especially for early detection and engagement with cancer screening programs.
“These findings are deeply concerning. Adults with learning disabilities are missing out on life-saving cancer treatment due to their cancer being found too late, and we urgently need to find out why this is case,” stressed lead study author Laura Ward, BSc, PhD, of the University of Dundee.
Study Methods and Results
In the study, the investigators found that adults with learning disabilities had a higher incidence of metastatic cancer of unknown primary origin. Further, the rate of mortality from this advanced stage of cancer was three times higher among the adults with learning disabilities compared with the mortality rate among those in the general population.
The most common cancer-related deaths were similar among women with and without learning disabilities—including breast cancer; gastrointestinal cancer, specifically colorectal cancer; and cancers of the respiratory system. However, women with learning disabilities had higher mortality rates from breast cancer, ovarian cancer, endometrial cancer, and cancers of unknown primary origin.
The most common cancer-related deaths in men with learning disabilities were found to mirror those of the general population, notably gastrointestinal cancer, specifically colorectal cancer, and cancers of the respiratory system. However, men with learning disabilities were more likely to die from colorectal cancer and cancers of unknown primary origin compared with those in the general population.
Conclusions
“It’s so important that [individuals] with learning disabilities, their families, and carers are supported to be aware of the signs and symptoms of cancer. Public health initiatives must consider the unique needs of [individuals] with learning disabilities, making screening more accessible and supporting earlier help-seeking for potential cancer symptoms,” suggested Susan Moug, BSc (Hons), MB ChB, PhD, FRCS, Honorary Professor and a consultant colorectal surgeon at the University of Glasgow.
“This is the first study in more than 20 years to report on the differences in cancer incidence and mortality between adults with learning disabilities and the general population. These startling findings highlight that [individuals] with learning disabilities continue to face significant health inequalities in all aspects of their lives, including a higher proportion of avoidable cancer deaths. Many cancers are preventable and/or treatable, and the more we raise awareness about early signs and symptoms, the more lives we are likely to save,” concluded senior study author Deborah Cairns, BSc, PhD, Director of the Scottish Learning Disabilities Observatory and Lead of the Cancer Programme at the University of Glasgow.
Disclosure: For full disclosures of the study authors, visit bmjopen.bmj.com.
