부산대학교 도서관

Background Limited evidence suggests that people with disabilities are more likely to be diagnosed with cancer at an advanced stage compared to people without disabilities. This has been linked to a reduced use of screening services and increased barriers to accessing care. Methods Using a mixed methods design the aim to generate understanding of the disparities in care experiences of people with disabilities on both the macro (organisational, and service delivery) and micro (personal) levels. Data linkage of routinely collected data and national survey data to explore disparities in cancer outcomes, comparing populations self-identifying as having a disability and a population not considered to have a disability. The outcomes explored included uptake of cancer screening services, later stage of cancer at diagnosis and risk cancer related mortality. Experiences of cancer service as someone with a pre-existing physical disability were explored using in-depth interviews and analysed using narrative analysis. Results Results showed that individuals with a disability were less likely to attend screening services, with reduced odds of having a mammogram (OR=0.66, 95% CI=0.58 to 0.74), cervical screen (OR=0.79, 95% CI= 0.70 to 0.87) and bowel screen 0.80 (95% CI=0.74 to 0.87). Results also ii showed people with disabilities were diagnosed with cancer at a later stage (OR=1.19, 95% CI= 0.88 to 1.61, p=0.27) and had a higher risk of cancer related mortality (1.67 (95% CI=1.34 to 2.08)). Qualitative findings found that people with pre-existing physical disabilities going through cancer care face additional barriers to receiving safe and timely care such as lack of suitable equipment, lack of staff knowledge and not feeling listened to. Conclusion The key thesis being put forward is that inequalities in cancer care do exist for people with disabilities on the wider level, shown through the quantitative analysis and on a personal level, shown through in-depth interviews.