Barriers to accessing cancer services in England and Wales by adults with physical disabilities


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Dikaios Sakellariou1,Sally Anstey2,Molly Courtenay2,Daniel Kelly3,Sarah Polack4,Eleri Girt5,Wendy Wilkinson5
1Cardiff University, Cardiff, UK ,2Cardiff University, Cardiff, UK,3Cardiff University,4London School of Hygiene and Tropical Medicine,5Wales Cancer Network, Cardiff, UK

Abstract

Background

There is evidence that people with disabilities are less likely to utilise cancer screening services and report low satisfaction and barriers to accessing these services. The aim of this study was to explore barriers to accessing cancer services in England and Wales faced by adults with pre-existing physical disabilities

Method

Exploratory qualitative study, conducted between October 2017 and October 2018. Data were collected by semi-structured interviews (n=18), and analysed thematically.

Results

Study findings indicated that people with physical disabilities, who go on to develop cancer, report several barriers relating to the receipt of acceptable levels of cancer care. Participants perceived healthcare systems and staff to be inadequately prepared to address their needs. Participants felt that their physical disability was often ignored, despite its importance in their lives. Even when healthcare professionals acknowledged the existence of their disability, participants found that professionals were not always adequately equipped to manage its effects on their care overall, and on their cancer-related care specifically. Other obstacles reported were travelling to and from the hospital, and mobilising within healthcare facilities.

Conclusion

In order to effectively address the needs of people with disabilities effectively, it is necessary to move beyond an exclusively single-disease approach to cancer management. This is becoming increasingly important as the population ages and greater numbers of people are living with cancer and disability. For healthcare services to be inclusive they need to be relevant and patient-centred, considering, and not ignoring or minimising, the disability and its effects on treatment. Necessary steps to be taken include enabling better communication between the different specialists involved in patients’ care, raising awareness of how disability can affect cancer-related treatment, striving for more accessible environments, and, ultimately, ensuring cancer services are disability-inclusive.