Health Informatics Centre, University of Dundee School of Medicine, Dundee, UK
Mental Health and Wellbeing, University of Glasgow School of Health and Wellbeing, Glasgow, UK.
BMJ Open. 2024 Aug 14;14(8):e084421. doi: 10.1136/bmjopen-2024-084421.
: : To provide contemporary data on cancer mortality rates within the context of incidence in the population with intellectual disabilities. : : Scotland's 2011 Census was used to identify adults with intellectual disabilities and controls with records linked to the Scottish Cancer Registry and death certificate data (March 2011-December 2019). The control cohort without intellectual disabilities and/or autism were used for indirect standardisation and calculation of crude incident rates/crude mortality rates, and age-sex standardised incident rate ratios/standardised mortality ratios (SIR/SMR), with 95% CIs. : : Adults with intellectual disabilities were most likely diagnosed cancers of digestive, specifically colorectal (14.2%), lung (9.3%), breast (female 22.9%), body of the uterus (female 9.3%) and male genital organs (male 17.6%). Higher incident cancers included metastatic cancer of unknown primary origin (female SIR=1.70, male SIR=2.08), body of uterus (female SIR=1.63), ovarian (female SIR=1.59), kidney (female SIR=1.85) and testicular (male SIR=2.49). SMRs were higher, regardless of a higher, similar or lower incidence (female SMR=1.34, male SMR=1.07). Excess mortality risk was found for colorectal (total SMR=1.54, male SMR=1.59), kidney (total SMR=2.01 u, female SMR=2.85 u), female genital organs (SMR=2.34 (ovarian SMR=2.86 u, body of uterus SMR=2.11), breast (female SMR=1.58) and metastatic cancer of unknown primary origin (female SMR=2.50 u, male SMR=2.84). : : Adults with intellectual disabilities were more likely to die of cancer than the general population. Reasons for this may include later presentation/diagnosis (so poorer outcomes), poorer treatment/compliance or both. Accessible public health approaches are important for people with intellectual disabilities, and healthcare professionals need to be aware of the different cancer experiences faced by this population.
: : 提供在具有智力障碍的人群中，癌症发病率背景下的癌症死亡率的当代数据。 : : 使用苏格兰 2011 年人口普查来识别有智力障碍的成年人和与苏格兰癌症登记处和死亡证明数据（2011 年 3 月至 2019 年 12 月）相关联的对照记录。没有智力障碍和/或自闭症的对照组用于间接标准化和计算粗发病率/粗死亡率、年龄性别标准化发病率比/标准化死亡率比（SIR/SMR），置信区间为 95%。 : : 有智力障碍的成年人最有可能被诊断出消化系统癌症，特别是结直肠癌（14.2%）、肺癌（9.3%）、乳腺癌（女性 22.9%）、子宫体（女性 9.3%）和男性生殖器官（男性 17.6%）。更高发的癌症包括未明原发灶转移癌（女性 SIR=1.70，男性 SIR=2.08）、子宫体（女性 SIR=1.63）、卵巢（女性 SIR=1.59）、肾脏（女性 SIR=1.85）和睾丸（男性 SIR=2.49）。无论发病率较高、相似还是较低，SMR 都较高（女性 SMR=1.34，男性 SMR=1.07）。发现结直肠癌（总 SMR=1.54，男性 SMR=1.59）、肾脏（总 SMR=2.01u，女性 SMR=2.85u）、女性生殖器官（SMR=2.34（卵巢 SMR=2.86u，子宫体 SMR=2.11）、乳腺癌（女性 SMR=1.58）和未明原发灶转移癌（女性 SMR=2.50u，男性 SMR=2.84）的死亡风险过高。 : : 与普通人群相比，有智力障碍的成年人更有可能死于癌症。原因可能包括较晚的表现/诊断（因此预后较差）、较差的治疗/依从性或两者兼而有之。为智力障碍者提供可及的公共卫生方法很重要，医护人员需要了解这一人群所面临的不同癌症经历。
