DISABILITY AND CANCER DIAGNOSIS FOLLOWING AN EMERGENCY PRESENTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS
1
School of Medicine, Vita-Salute San Raffaele, University, Milan, Italy
2
PhD National Programme in One Health approaches to infectious diseases and life science research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
3
Research Department of Behavioural Science and Health, University College London, London, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):A2987
ABSTRACT
BACKGROUND:
People with disabilities (PwD) face inequalities in accessing appropriate healthcare, with worse outcomes compared to the general population. Little is known about their cancer risk after Emergency Presentation (EP), linked to poor survival. This review aims to summarise evidence on EP risk among PwD.
METHODS:
Following PRISMA 2020 guidelines, we systematically searched three databases (PubMed/MEDLINE, Embase and Scopus), including experimental or observational studies on cancer diagnosis after EP in PwD. Disability categories included physical, sensory, cognitive, intellectual, learning, functional, and psychosocial disabilities. We estimated the overall risk of EP for PwD, and risks for specific disability categories where data was available. Risk of bias was evaluated using the Mixed Methods Appraisal Tool (MMAT). A random-effects meta-analysis was performed. This work is part of the Cariplo-funded “Intrecci” project.
RESULTS:
Among 10940 records screened, 6 studies met the inclusion criteria. Included studies were from high-income countries and examined intellectual, cognitive, psychosocial or physical disabilities. Overall, PwD compared to those without, had higher odds of being diagnosed with cancer following an EP(OR=1.53, 95%CI:1.16–2.03), with substantial heterogeneity (I²=96.27%). Subgroup analyses showed increased odds of EP for colorectal cancer among PwD (OR=1.75, 95%CI:1.22–2.51). The risks of EP for those with psychosocial disability and for cognitive conditions were: OR=1.15, 95% CI:1.01–1.31 and OR=2.55, 95%CI:1.91-3.39, respectively. MMAT scores indicated high methodological quality for most studies.
CONCLUSIONS:
The available evidence indicates a higher risk of cancer diagnosis following an EP for PwD. This might be due to barriers at multiple stages of the diagnostic process, including screening, symptom appraisal, help-seeking, and access to investigation. Reducing EP is a key public health priority, as it is associated with sub-optimal care and worse outcomes. High-quality studies are urgently needed to identify where delays occur to inform interventions promoting inclusive and equitable cancer diagnosis and care.
People with disabilities (PwD) face inequalities in accessing appropriate healthcare, with worse outcomes compared to the general population. Little is known about their cancer risk after Emergency Presentation (EP), linked to poor survival. This review aims to summarise evidence on EP risk among PwD.
METHODS:
Following PRISMA 2020 guidelines, we systematically searched three databases (PubMed/MEDLINE, Embase and Scopus), including experimental or observational studies on cancer diagnosis after EP in PwD. Disability categories included physical, sensory, cognitive, intellectual, learning, functional, and psychosocial disabilities. We estimated the overall risk of EP for PwD, and risks for specific disability categories where data was available. Risk of bias was evaluated using the Mixed Methods Appraisal Tool (MMAT). A random-effects meta-analysis was performed. This work is part of the Cariplo-funded “Intrecci” project.
RESULTS:
Among 10940 records screened, 6 studies met the inclusion criteria. Included studies were from high-income countries and examined intellectual, cognitive, psychosocial or physical disabilities. Overall, PwD compared to those without, had higher odds of being diagnosed with cancer following an EP(OR=1.53, 95%CI:1.16–2.03), with substantial heterogeneity (I²=96.27%). Subgroup analyses showed increased odds of EP for colorectal cancer among PwD (OR=1.75, 95%CI:1.22–2.51). The risks of EP for those with psychosocial disability and for cognitive conditions were: OR=1.15, 95% CI:1.01–1.31 and OR=2.55, 95%CI:1.91-3.39, respectively. MMAT scores indicated high methodological quality for most studies.
CONCLUSIONS:
The available evidence indicates a higher risk of cancer diagnosis following an EP for PwD. This might be due to barriers at multiple stages of the diagnostic process, including screening, symptom appraisal, help-seeking, and access to investigation. Reducing EP is a key public health priority, as it is associated with sub-optimal care and worse outcomes. High-quality studies are urgently needed to identify where delays occur to inform interventions promoting inclusive and equitable cancer diagnosis and care.
| eISSN: | 2654-1459 |
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