The Intersection of Disability and Cancer: Improving Outcomes in Cancer Patients With Disabilities

To evaluate the barriers to timely health care access and health-related outcomes among patients with disabilities diagnosed with cancer.

People with disabilities face unique challenges in navigating health care systems, including structural and socioeconomic barriers. These challenges may delay cancer diagnosis and treatment; however, they remain underexplored.

Patients diagnosed with breast, lung, colorectal, melanoma, pancreatic, and esophageal cancers were identified from the All of Us Research Program. The patients were stratified by disability status based on self-reported impairments in mobility, hearing, vision, communication, or cognition. Propensity score matching was performed to balance groups. Outcomes included health care access, financial burden, and physical and emotional health.

Among 18,260 patients with cancer, 4546 (24.9%) reported a disability. Patients with disabilities were older (67 vs 65 y), Hispanic (10.2% vs 6.7%) or Black (17.3% vs 9.9%), had lower household incomes (<50k: 59% vs 25.8%), and were unemployed (76.5% vs 46.6%) (all P <0.001). After matching, patients with disabilities reported higher rates of out-of-pocket costs (15% vs 11.3%, P <0.001), lack of transportation (10.8% vs 3.8%, P <0.001), as well as greater difficulty accessing medications, mental health counseling, specialty care, and follow-up care (all P <0.001). Those with disabilities reported worse physical and mental health, higher pain scores, and lower quality of life (all P <0.001).

Individuals with disabilities and cancer face significant disparities in access to timely and affordable care, which contributes to poorer health outcomes. Further research is needed to better understand and address these barriers, as well as identify potential interventions to close the gap in health care inequities for this vulnerable population.