Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Lancet Oncol. 2022 Apr;23(4):e164-e173. doi: 10.1016/S1470-2045(22)00018-3.
About 15% of the global population-more than 1 billion people-have a disability. People with early-onset disability are now living into middle and older ages and are therefore at risk for adult cancer. Overall, disabled people are more disadvantaged in social determinants of health and are more likely to have risk factors associated with cancer than people without disabilities. People with disabilities often experience disparities in breast and cervical cancer screening compared with people who do not have disabilities, and patterns in colorectal cancer screening disparities are inconsistent. The minimal evidence that exists relating to the timeliness of cancer diagnosis, treatment, and outcomes for people with disabilities suggests differential treatment and higher cancer-related mortality than for people without disabilities. Worldwide, disabled people face barriers to obtaining cancer care, including inaccessible medical diagnostic equipment, ineffective communication accommodations, and potentially biased attitudes among clinicians. Ensuring equitable cancer care for people with disabilities will therefore require eliminating not only physical but also attitude-based barriers to their care.
全球约有 15%的人口，也就是超过 10 亿人存在残疾。早发性残疾人群现在已经进入中年和老年，因此面临成人癌症的风险。总的来说，残疾人群在健康的社会决定因素方面处于更为不利的地位，并且比非残疾人群更容易出现与癌症相关的风险因素。与没有残疾的人相比，残疾人在乳腺癌和宫颈癌筛查方面往往存在差异，而结直肠癌筛查差异的模式并不一致。关于残疾人群癌症诊断、治疗和结果的及时性的现有证据很少，这表明残疾人群的治疗存在差异，癌症相关死亡率更高。在全球范围内，残疾人群在获得癌症治疗方面面临障碍，包括无法使用医疗诊断设备、沟通障碍以及临床医生潜在的偏见态度。因此，确保残疾人群获得公平的癌症护理不仅需要消除身体上的障碍，还需要消除基于态度的障碍。
