Disparities in cancer-related healthcare among people with intellectual disabilities: A population-based cohort study with health insurance claims data
Publication year
2020Source
Cancer Medicine, 9, 18, (2020), pp. 6888-95ISSN
Publication type
Article / Letter to editor
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Organization
Primary and Community Care
Health Evidence
Journal title
Cancer Medicine
Volume
vol. 9
Issue
iss. 18
Page start
p. 6888
Page end
p. 95
Subject
Radboudumc 15: Urological cancers RIHS: Radboud Institute for Health Sciences; Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health SciencesAbstract
BACKGROUND: Concerns have been raised about the accessibility and quality of cancer-related care for people with intellectual disabilities (ID). However, there is limited insight into cancer incidence and the utilization of cancer care at the ID population level to inform targeted cancer control strategies. Therefore, we aimed to examine differences in the utilization of cancer-related care between people with and without ID, identified through diagnostic codes on health insurance claims. METHODS: In a population-based cohort study, Dutch individuals of all ages who received residential care through the Chronic Care Act due to an ID (n = 65 183) and an age and sex-matched sample of persons without ID (1:2 ratio), who were cancer-free at enrollment in 2013 were followed through 2015. Incidence rates (IRs) of newly started cancer care and IR ratios (IRRs) with 95% CIs were used to compare groups. Separate analyses were performed per cancer type. RESULTS: Individuals with ID received less cancer-related care than individuals without (IRR = 0.64, 95% CI 0.62-0.66). Differences increased with age and were larger for females than for males. Utilization of care for cancers within the national screening program (female breast, cervical, and colon cancer) was lower for people with ID compared to people without ID. CONCLUSION: Cancer may be underdiagnosed and/or undertreated in people with ID, or cancer is truly less prevalent in this population. In particular, the differences detected between males and females with ID, and the potential underutilization of national screening programs, require urgent follow-up investigations.
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- Academic publications [238441]
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- Faculty of Medical Sciences [90373]
- Open Access publications [97506]
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