Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Cancer. 2022 Mar 15;128(6):1267-1274. doi: 10.1002/cncr.34030. Epub 2021 Nov 17.
Concerns have been raised about access to cancer screening and the timely receipt of cancer care for people with an intellectual disability (ID). However, knowledge about cancer mortality as a potential consequence of these disparities is still limited. This study, therefore, compared cancer-related mortality patterns between people with and without ID.
A historical cohort study (2015-2019) linked the Dutch adult population (approximately 12 million people with an ID prevalence of 1.45%) and mortality registries. Cancer-related mortality was identified by the underlying cause of death (according to the chapter on neoplasms in the International Classification of Diseases, Tenth Revision). Observed mortality and calculated age- and sex-standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) were reported.
There were 11,102 deaths in the ID population (21.7% cancer-related; n = 2408) and 730,405 deaths in the general population (31.2%; n = 228,120) available for analysis. Cancer was noted as the cause of death more often among people with ID in comparison with the general population (SMR, 1.48; 95% CI, 1.42-1.54), particularly in the young age groups. High-mortality cancers included cancers within the national screening program (SMRs, 1.43-1.94), digestive cancers (SMRs, 1.24-2.56), bladder cancer (SMR, 2.07; 95% CI, 1.61-2.54), and cancers of unknown primary (SMR, 2.48; 95% CI, 2.06-2.89).
Cancer was reported as the cause of death approximately 1.5 times more often in people with ID compared with the general population. This mortality disparity may indicate adverse effects from inequalities in screening and cancer care experienced by people with ID.
People with an intellectual disability (ID) may find it challenging to participate in cancer screening or to receive timely cancer care. To understand potential consequences in terms of mortality, this study compared cancer-related mortality between people with and without ID in the Netherlands. Cancer was reported as the cause of death approximately 1.5 times more often among people with ID than others. Because large differences were found that were related to screening cancers and cancers for which the primary tumor was unknown, this study's results raise concerns about equality in screening practices and cancer care for people with ID.
人们对智障人士（ID）接受癌症筛查和及时获得癌症护理的机会表示担忧。然而，对于这些差异可能导致的癌症死亡率相关知识仍然有限。因此，本研究比较了 ID 患者和非 ID 患者的癌症相关死亡率模式。
这是一项历史队列研究（2015-2019 年），将荷兰成年人群（约有 1200 万 ID 患者，患病率为 1.45%）与死亡率登记处相关联。根据国际疾病分类第十版（ICD-10）中肿瘤章节确定癌症相关死亡率。报告了观察死亡率和计算的年龄和性别标准化死亡率比（SMR）及 95%置信区间（CI）。
ID 人群中有 11102 人死亡（21.7%与癌症相关；n=2408），一般人群中有 730405 人死亡（31.2%；n=228120），可供分析。与一般人群相比，ID 患者的死亡原因中癌症更为常见（SMR，1.48；95%CI，1.42-1.54），特别是在年轻年龄组中。高死亡率癌症包括国家筛查计划中的癌症（SMR，1.43-1.94）、消化系统癌症（SMR，1.24-2.56）、膀胱癌（SMR，2.07；95%CI，1.61-2.54）和不明原发性癌症（SMR，2.48；95%CI，2.06-2.89）。
与一般人群相比，ID 患者的死亡原因中癌症报告约多 1.5 倍。这种死亡率差异可能表明 ID 患者在筛查和癌症护理方面存在不平等，从而产生了不利影响。
说明：本文的译文以自然语言形式输出，未包含任何额外信息或解释。
