Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands.
Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands.
Lancet Oncol. 2022 Apr;23(4):e174-e183. doi: 10.1016/S1470-2045(21)00694-X.
Adults with intellectual disabilities face disparities in receipt of cancer-related care, which could contribute to an increase in the rate of cancer-related deaths in this population. Yet, relatively little is known about the optimal cancer treatment or treatment decision making in adults with intellectual disabilities. This scoping review assessed PubMed and Embase for available literature on the description of cancer treatment and treatment decision making in patients with intellectual disabilities, published in English between Jan 1, 2000, and April 30, 2020. We appraised 90 included articles and extracted quotes addressing aspects related to cancer treatment and treatment decision making in patients with intellectual disabilities. Themes and subcategories were subsequently derived. Our findings revealed that the available literature describes that people with intellectual disabilities tend to have less intensive cancer treatment than generally administered, but with little evidence supporting this approach. This finding indicates that this medically vulnerable patient population needs tailored attention in both cancer care and research. We propose changes to practice and conclude by addressing the urgent need to pay specific attention to this patient population.
成年智障患者在接受癌症相关治疗方面存在差异，这可能导致该人群癌症相关死亡率上升。然而，对于智障成年人的最佳癌症治疗或治疗决策，人们知之甚少。本范围综述评估了 2000 年 1 月 1 日至 2020 年 4 月 30 日期间在英文期刊上发表的关于智障患者癌症治疗和治疗决策描述的 PubMed 和 Embase 可用文献。我们评估了 90 篇纳入的文章，并提取了涉及智障患者癌症治疗和治疗决策方面的引用。随后得出了主题和子类别。我们的研究结果表明，现有文献表明智障患者的癌症治疗强度往往低于一般治疗，但几乎没有证据支持这种方法。这一发现表明，这一医学上脆弱的患者群体在癌症护理和研究中都需要特别关注。我们提出了实践上的改变，并通过解决特别关注这一患者群体的迫切需要来结束报告。
