# A literature review of cancer diagnostic tests and treatments in adults with intellectual disability

## TL;DR

This paper reviews how adults with intellectual disabilities face challenges in cancer screening and treatment, highlighting the need for adapted approaches and education.

## Contribution

The study systematically identifies barriers and solutions for cancer care in adults with intellectual disabilities through thematic analysis of existing literature.

## Key findings

- Barriers include limited screening education, distrust in healthcare providers, and inability to provide consent.
- Educational tools and adapted treatment plans improve cancer screening uptake and reduce anxiety.
- Autonomy and patient involvement in decision-making are emphasized as critical factors for effective care.

## Abstract

Adults with intellectual disabilities have significantly lower rates of routine cancer screening and cancer is often diagnosed at more advanced stages. Some studies specifically highlight gaps that exist in national screening programmes for cancers such as breast, cervical and colorectal. Evidence in the intellectual disability population points towards factors such as limited screening education, distrust in healthcare providers, and inability to provide consent, leading to limited uptake of available screening programmes. While there are many contributing factors to these inequalities, changes in individuals' health status may go unrecognised for significantly longer because of their intellectual disability.

Five electronic databases were systematically searched: Cinahl Ultimate, Medline, PsycINFO, PubMed, and Web of Science. To provide the most accurate search, search functionality and keywords were used and adjusted for each database. Thematic analysis was completed using the Braun and Clark Six Step process.

Four main themes emerged: Prevention, education, adaptation, and autonomy. Prevention encompassed individuals receiving regular screening and barriers that prevented access. Educational tools that explained the importance of screening reduced feelings of stress and anxiety. Case studies illustrated how specific treatment plans were adapted for patients with intellectual disabilities. Autonomy and honesty were themes throughout many studies, in terms of treatment, education, and diagnostics. It was determined that patients should be involved in decision making and be aware of their cancer diagnosis unless there are contra-indications.

Adults with intellectual disabilities face considerable barriers when accessing cancer diagnosis and treatment. Barriers, including living conditions, communication difficulties and age, contributed to later cancer diagnosis and worse outcomes, compared to the general population. The successful use of education and tailored treatments were enabling factors.