Barriers to screening and early cancer diagnosis in people living with mental health conditions or a learning disability: A qualitative study on patient experiences and healthcare providers’ perspectives
1
1 Department of Behavioural Science and Health, University College London, London, United Kingdom
2
2 School of Health Sciences, University of Surrey, Surrey, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):A2994
ABSTRACT
BACKGROUND:
People with a mental health condition (MHC) or learning disability (LD) can face significant barriers accessing healthcare, experiencing higher risks of diagnostic delays and advanced stage cancer diagnosis compared to the wider population. Limited evidence is available on specific barriers to screening and early diagnosis from both the perspectives of people with MHC or LD and healthcare professionals.
METHODS:
We performed online semi-structured interviews with 27 UK-based people with MHC or LD and/or carers, and 24 healthcare professionals. Experiences and perspectives on cancer screening, diagnostic investigations for potential cancer symptoms, and service improvement suggestions were explored. Patient and public involvement activities supported study material development. We used an inductive analysis to identify key barriers and areas for improvement, integrating findings from people with MHC or LD and healthcare professionals.
RESULTS:
Examining interviews with people with MHC (55% depression), carers of LD (71% Down’s syndrome), and healthcare professionals (58% general practitioners), three overarching themes emerged: 1) communication issues between patients/carers and healthcare professionals; 2) self-stigma and healthcare professional stigma; 3) systemic and structural barriers. People with MHC highlighted dehumanisation as a barrier, while lack of complaining when experiencing symptoms was noted by carers of people with LD. General practitioners emphasised patients’ limited health literacy in screening benefits, while mental health professionals perceived emotional burden and low motivation for preventive behaviours as barriers among these populations. Participants suggested structural and informational improvements within diagnostic pathways, including flagging vulnerable patients to appropriately plan appointments and reduce sensory over-exposure. Suggestions to train healthcare professionals to address stigma also emerged.
CONCLUSIONS:
Despite national healthcare standards promoting reasonable adjustments for people with MHC or LD, study participants highlighted considerable deficiencies in their implementation. Integrating patient and healthcare perspectives are necessary for developing tailored approaches to reduce barriers and improve equitable access to early cancer diagnosis.
People with a mental health condition (MHC) or learning disability (LD) can face significant barriers accessing healthcare, experiencing higher risks of diagnostic delays and advanced stage cancer diagnosis compared to the wider population. Limited evidence is available on specific barriers to screening and early diagnosis from both the perspectives of people with MHC or LD and healthcare professionals.
METHODS:
We performed online semi-structured interviews with 27 UK-based people with MHC or LD and/or carers, and 24 healthcare professionals. Experiences and perspectives on cancer screening, diagnostic investigations for potential cancer symptoms, and service improvement suggestions were explored. Patient and public involvement activities supported study material development. We used an inductive analysis to identify key barriers and areas for improvement, integrating findings from people with MHC or LD and healthcare professionals.
RESULTS:
Examining interviews with people with MHC (55% depression), carers of LD (71% Down’s syndrome), and healthcare professionals (58% general practitioners), three overarching themes emerged: 1) communication issues between patients/carers and healthcare professionals; 2) self-stigma and healthcare professional stigma; 3) systemic and structural barriers. People with MHC highlighted dehumanisation as a barrier, while lack of complaining when experiencing symptoms was noted by carers of people with LD. General practitioners emphasised patients’ limited health literacy in screening benefits, while mental health professionals perceived emotional burden and low motivation for preventive behaviours as barriers among these populations. Participants suggested structural and informational improvements within diagnostic pathways, including flagging vulnerable patients to appropriately plan appointments and reduce sensory over-exposure. Suggestions to train healthcare professionals to address stigma also emerged.
CONCLUSIONS:
Despite national healthcare standards promoting reasonable adjustments for people with MHC or LD, study participants highlighted considerable deficiencies in their implementation. Integrating patient and healthcare perspectives are necessary for developing tailored approaches to reduce barriers and improve equitable access to early cancer diagnosis.
| eISSN: | 2654-1459 |
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