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Published on: December 15, 2023
Promoting High-Quality, Accessible Cancer Care for People With Disabilities
Sean Smith1, Maggie Salinger2, Rebecca A Spence3
1Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
Abstract:
People with disabilities (PWD) face numerous challenges throughout the continuum of cancer care. Many of these are due to personal and structural biases that have historically made it more difficult for PWD to access oncologic care and which can be dehumanizing. We provide a narrative review of these challenges, starting with a review of disability statistics and methodologic considerations when reviewing the epidemiology of disability. We then discuss historic legal frameworks designed to support PWD, and barriers to oncology care faced by PWD, organized around the following primary topics: (1) biases faced by PWD from health care professionals, (2) screening, (3) diagnosis, (4) treatment, (5) survivorship, and (6) historical exclusion from oncology research. We conclude by identifying key areas that must be addressed to provide high-quality oncologic care for PWD. A variety of suggestions for addressing these issues are presented, including additional education of oncology providers, rethinking performance status, engaging stakeholders in the disability community, improving enrollment in clinical trials for PWD, and collecting consistent disability-related data.
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