Factors Associated With the Receipt of Female Breast Cancer Treatment Among People Living With Intellectual or Developmental Disabilities: A Population-Based Retrospective Cohort Study.
A quick family-doctor interview recorded in the chart boosts the odds that women with IDD receive the breast-cancer treatment they need.
01Research in Context
What this study did
Researchers looked back at medical records for 365 women who have intellectual or developmental disabilities and breast cancer.
They wanted to know which women actually got the cancer care guidelines say they should get.
The team checked age, cancer stage, lymph-node spread, and whether a family doctor had talked with the woman.
What they found
Older women, later-stage tumors, and cancer in the lymph nodes made guideline care less likely.
One simple thing helped: if records showed a family-physician interview happened, the woman was more likely to receive the right treatment.
How this fits with other research
Chiviacowsky et al. (2013) saw the same pattern in Canada. Adults with IDD living in rural or high-First-Nations areas landed in the hospital for problems primary care could have caught.
Both studies say the same thing: without a regular doctor who knows the patient, people with IDD slip through the cracks.
Magaña et al. (2016) add that Black and Latino adults with IDD face even steeper health gaps. The new breast-cancer data extend that idea—disability plus any other risk factor stacks the deck against proper care.
Why it matters
If you serve adults with IDD, schedule and document a face-to-face chat with their family physician before any major medical decision. That single logged conversation can be the bridge that gets your client from diagnosis to actual treatment. Push for it in the care plan and keep the note in the file—hospitals look for it.
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02At a glance
03Original abstract
BACKGROUND: People with intellectual or developmental disabilities (IDD) experience breast cancer care inequities relative to those without IDD. Identifying factors associated with receipt of breast cancer treatment among those with IDD is needed to provide guidance and inform resources for improving patient-centred care. This study explores factors associated with receipt of breast cancer treatment among individuals with IDD. METHODS: We conducted a population-based retrospective cohort study with administrative health data in Ontario, Canada. Adults with IDD diagnosed with Stage I-III female breast cancer between 2007 and 2018 were included. We examined factors associated with receipt of breast cancer treatment based on stage-specific guideline recommendations. Sociodemographic (e.g., age, region, and rurality), clinical (e.g., comorbidities), cancer-related (e.g., stage at diagnosis and nodal status) and health system (e.g., family interview with a physician) factors associated with overall treatment, surgical resection, mastectomy and radiation were explored using modified Poisson regression with robust standard error variance. Crude and adjusted risk ratios with 95% confidence intervals were estimated. RESULTS: The overall treatment cohort, surgical resection cohort, mastectomy cohort and radiation cohort included 365, 365, 333 and 138 females with IDD, respectively. Age, stage at diagnosis and lymph node status were significantly associated with overall breast cancer treatment. We identified that age, grade, lymph node status and radiation consult were significantly associated with surgical resection receipt. Among individuals who received surgery, those who were older, who had more advanced stages at diagnosis or who had a family interview were more likely to have mastectomy rather than breast-conserving surgery. Age and lymph node status were significantly associated with receipt of radiation. CONCLUSIONS: Sociodemographic, clinical, cancer-related and health system factors were associated with receipt of breast cancer treatment in a sample of breast cancer patients with IDD. Overall, these findings suggest that health system factors could contribute to disparities in treatment among individuals with IDD diagnosed with breast cancer.
Journal of intellectual disability research : JIDR, 2026 · doi:10.1111/jir.70089