BACKGROUND:
People with disabilities often face barriers to early cancer diagnosis with poorer outcomes. Aligned with the Convention on the Rights of Persons with Disabilities (CRPD), this project addresses diagnostic inequities through a multidisciplinary lens, investigating socio-cultural, environmental and organizational barriers.

METHODS:
In the Project Intrecci we employed a multimethods approach, bridging epidemiology, architecture, and qualitative research to identify specific barriers to early cancer diagnosis for people with disabilities. Analyzing electronic health records and cancer registry data in Lombardy, northern Italy, we compared diagnostic pathways, stage, and mortality between patients with and without various types of disabilities. Additionally, we conducted qualitative interviews with patients/caregivers and healthcare professionals, exploring lived experiences and perceptions on barriers and stigma across diagnostic pathways. Using the “Design for All A.U.D.I.T.” tool, we evaluated physical, sensory, and cognitive accessibility of diagnostic centers. We engaged with disability-led organizations as project partners, supporting study prioritization, refining accessibility checklists, interpreting findings, and co-designing recommendations and implementation tools.

RESULTS:
Population-based analyses showed that people with disabilities have a significantly higher risk of emergency cancer diagnosis (aOR=1.48, 95%CI: 1.39-1.58) and poorer survival, independently of stage or comorbidities. Qualitative investigations identified critical barriers, including communication difficulties, stigma-driven assumptions, fragmented care, and sub-optimal accessibility of some diagnostic equipment. Protective factors included therapeutic alliances, family involvement, and improved interdisciplinary coordination. The integrated findings are being used to inform active engagement with disability associations to co-design accessible solutions and the implementation of targeted training initiatives for medical students and nurses, fostering disability-inclusive care among future healthcare professionals.

CONCLUSIONS:
The project operationalizes a CRPD-consistent approach to health equity, through active partnership with disability-led organizations and integrating population-based quantitative evidence with qualitative insights and environmental accessibility assessments. This offers actionable tools for policymakers and healthcare providers to reduce diagnostic barriers and build inclusive cancer pathways.