Barriers to Cancer Diagnosis for People with Disabilities: a qualitative study with patients and healthcare providers in Northern Italy
1
Università Vita-Salute San Raffaele, Milan, Italy
2
PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Dipartimento di Sanità Pubblica, Medicina Sperimentale e Forense, Università di Pavia, Pavia, Italy
3
IRCCS Ospedale San Raffaele, Milan, Italy
4
Research Department of Behavioural Science and Health, University College London, London, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):A2741
ABSTRACT
BACKGROUND:
Despite increasing attention to healthcare equity, people with disabilities (PwD) have a higher risk of delays is cancer diagnosis and poorer survival than the general population. Evidence on specific barriers along cancer diagnostic pathways remains scarce. To inform actionable strategies for inclusive cancer care, this study aims to provide insights on barriers to cancer screening and diagnostic investigations for PwD in Lombardy, Northern Italy.
METHODS:
We conducted semi-structured interviews (in person or online) with PwD, caregivers, and healthcare professionals (HCPs) in Lombardy, Northern Italy. The interviews explored lived experiences and perspectives on specific barriers to cancer screening and diagnosis, and potential facilitators for early cancer diagnosis. We used inductive analysis to integrate findings across patients, carers and HCP. Patient and public involvement activities supported study material development. Preliminary
RESULTS:
Preliminary analyses include 33 interviews with HCPs (14.3% physicians; 67% with over 10 years of work experience) and PwD (41.7% psychiatric, 33.3% intellectual, and 25% physical or sensory disabilities), with a mean interview duration of 30 minutes. Key barriers highlighted by HCPs included communication difficulties, fragmented care, and assumptions regarding patients’ fear of cancer. PwD reported limited knowledge of screening programs, feelings of being a burden, communication challenges and physical inaccessibility of diagnostic equipment. HCP-related stigma and self-stigma emerged as important barriers across interviews. Participants highlighted possible facilitators for early diagnosis, including strong therapeutic alliances, active family involvement, improved interdisciplinary communication, and heightened HCP awareness.
CONCLUSIONS:
Preliminary findings underscore the need for improved interdisciplinary communication and coordination of cancer diagnostic pathways, with stronger therapeutic alliances with families. Educational interventions reducing stigma among healthcare professionals and self-stigma among PwD are also key. The study will generate evidence-based recommendations for co-designing interventions to foster more inclusive and person-centered cancer pathways.
Despite increasing attention to healthcare equity, people with disabilities (PwD) have a higher risk of delays is cancer diagnosis and poorer survival than the general population. Evidence on specific barriers along cancer diagnostic pathways remains scarce. To inform actionable strategies for inclusive cancer care, this study aims to provide insights on barriers to cancer screening and diagnostic investigations for PwD in Lombardy, Northern Italy.
METHODS:
We conducted semi-structured interviews (in person or online) with PwD, caregivers, and healthcare professionals (HCPs) in Lombardy, Northern Italy. The interviews explored lived experiences and perspectives on specific barriers to cancer screening and diagnosis, and potential facilitators for early cancer diagnosis. We used inductive analysis to integrate findings across patients, carers and HCP. Patient and public involvement activities supported study material development. Preliminary
RESULTS:
Preliminary analyses include 33 interviews with HCPs (14.3% physicians; 67% with over 10 years of work experience) and PwD (41.7% psychiatric, 33.3% intellectual, and 25% physical or sensory disabilities), with a mean interview duration of 30 minutes. Key barriers highlighted by HCPs included communication difficulties, fragmented care, and assumptions regarding patients’ fear of cancer. PwD reported limited knowledge of screening programs, feelings of being a burden, communication challenges and physical inaccessibility of diagnostic equipment. HCP-related stigma and self-stigma emerged as important barriers across interviews. Participants highlighted possible facilitators for early diagnosis, including strong therapeutic alliances, active family involvement, improved interdisciplinary communication, and heightened HCP awareness.
CONCLUSIONS:
Preliminary findings underscore the need for improved interdisciplinary communication and coordination of cancer diagnostic pathways, with stronger therapeutic alliances with families. Educational interventions reducing stigma among healthcare professionals and self-stigma among PwD are also key. The study will generate evidence-based recommendations for co-designing interventions to foster more inclusive and person-centered cancer pathways.
| eISSN: | 2654-1459 |
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