Results of an analysis of cross-sectional data from the 2010 to 2017 National Health Interview Surveys (NHIS) suggest that individuals with a pre-existing disability may be at increased risk for certain cancers. These findings were reported in the Journal of the National Comprehensive Cancer Network.1
It has been estimated that over 25% of the US population has some type of disability. Furthermore, the incidence of a number of cancer risk factors, including tobacco use, obesity, and poverty have been reported to be higher in this group compared with those without a disability. Nevertheless, many questions related to the prevalence and diagnosis of cancer in those with a pre-existing disability have not been well explored.
Researchers investigated the association between 4 common cancers — colorectal, prostate, ovarian, and non-Hodgkin lymphoma — and a chronic disability related to movement difficulties (MD) or complex activity limitations (CAL) that predated and were unrelated to the patient’s cancer diagnosis.
A key finding of this study was significantly higher rates of all 4 cancers in patients with a pre-existing disability characterized by MD or CAL compared with those without this type of disability. For example, the rates of prostate cancer were 3.38% and 3.13% in men with a pre-existing MD or CAL, respectively, compared with 1.26% in those without MD or CAL ( P <.0001).
In addition, compared with those without pre-existing MD or CAL, the mean age of individuals with pre-existing MD or CAL was significantly higher for those diagnosed with colorectal cancer, prostate cancer, and NHL. For instance, the mean age at colorectal cancer diagnosis was 62.6 years for those with a pre-existing MD compared with 55.9 years (P <.0001) for those without pre-existing MD or CAL.
Furthermore, on multivariable analyses adjusting for potential confounding factors, such as known cancer risk factors and sociodemographic characteristics, the respective adjusted odds ratios (aORs) for those with pre-existing MD or CAL were 1.5 (P <.001) and 1.9 (P <.001) for colorectal cancer, 1.2 (P =.14) and 1.5 (P <.01) for NHL, 1.4 (P =.15) and 1.5 (P =.10) for ovarian cancer, and 1.2 (P =.03) and 1.1 (P =.11) for prostate cancer compared to those without such as disability.
Although noting that this analysis was limited to identifying associations between disability and cancer and not causality, the study authors stated that “our population-based analyses suggest that persons with disability should perhaps be considered a high-risk population, with higher cancer incidence.”
Furthermore, in commenting on this analysis, authors of an accompanying commentary emphasized that “making disability-disaggregated data available is one step toward bridging cancer disparities for people with disabilities.”2
- Iezzoni LI, Rao SR, Agaronnik ND, El-Jawahri A. Cross-sectional analysis of the associations between four common cancers and disability. J Natl Compr Canc Netw. 2020;18:1031-1044. doi:10.6004/jnccn.2020.7551.
- Sakellariou D, Rotarou ES. Cancer disparities for people with disabilities: bridging the gap. J Natl Compr Canc Netw. 2020;18:1144-1146. doi:10.6004/jnccn.2020.7614.