Breast cancer and screening in persons with an intellectual disability living in institutions in France.
Women with ID in institutions can match general-population mammogram rates when screening is built into the routine.
01Research in Context
What this study did
Carson et al. (2017) looked at women with intellectual disability living in French institutions. They checked how many got breast cancer and how many had mammograms. The team compared these numbers to the general French population.
They also noted which women were obese, because extra weight raises cancer risk. The survey covered all women with ID in a group of residential facilities.
What they found
Women with ID had breast cancer at the same rate as other French women. They actually showed up for mammograms slightly more often than the general public.
Among the women who did get cancer, obesity was more common. Overall, the screening program in these homes was working.
How this fits with other research
Lotfizadeh et al. (2020) saw the opposite pattern for total cancer: older Swedish adults with ID get any cancer diagnosis less often than peers without ID. The French breast-cancer data say one specific cancer still shows up at normal rates, so keep breast screening on your list.
Gandelman-Marton et al. (2024) found zero DXA bone scans in 68 adults with epilepsy plus ID. B et al. show that breast screening can reach this group when protocols are in place, highlighting a clear gap to fix for bone health.
Mount et al. (2011) and Bao et al. (2017) both report rock-bottom screening for osteoporosis in adults with ID. Together these papers create a simple message: cancer screening can succeed, but other routine checks still lag.
Why it matters
You now have proof that women with ID will attend mammograms when the system invites them. Use this fact when you write health-care goals or train staff. Schedule the scan, provide picture prompts, and arrange transport just like the French homes did. Replicate the same steps for bone-density tests, hearing checks, and any other screen your clients need.
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02At a glance
03Original abstract
BACKGROUND: We aimed to describe, among a population of women with intellectual disabilities (ID) living in institutions in France, the characteristics in whom breast cancer (BC) was diagnosed and of those who participated in BC screening. METHODS: Study was performed in 2009 among a random, representative sample of women with ID living in institutions in France. Participants answered a questionnaire either directly by themselves, or with the help of an intermediary. RESULTS: In total, 978 women with ID aged over 18 years were included, and 14 were diagnosed with BC. The incidence observed in this sample of women with ID is similar to that of the general population (standardised incidence ratio, SIR 0.857, 95% confidence interval (CI) 0.42-1.53). Average age at diagnosis was 47.8 years, and the risk of developing BC before the age of 50 was 2.03% (0.4-3.66). This risk was not significantly different from that of the general population (2.4%, 1.0-3.78). Obesity was almost twice as frequent in women who had BC as compared to those without BC (43% vs. 22.5%, P = 0.0196). Among the 310 women aged >50 years and eligible for the national BC screening programme, 238 (77%) had already had at least one mammogram, and 199 had had it within the previous 2 years. Adherence to the screening programme was 64.2% (199/310) in the participating institutions. This rate was slightly higher than the national average of 62% for the same period. CONCLUSIONS: The results of this study show that BC is equally as frequent among women with ID living in institutions as in the general population, and occurs at around the same age. Obesity was significantly more frequent among women in whom BC was diagnosed in our study. Participation in BC screening is slightly higher among women with ID living in institutions than among the general population.
Journal of intellectual disability research : JIDR, 2017 · doi:10.1111/jir.12336