Disability related disparities in diagnosis and survival of digestive system cancers in Northern Italy

Abstract

Abstract Individuals with disabilities may experience disparities in cancer diagnosis, but population-based evidence remains limited. We conduct a population-based cohort study using linked cancer registry and administrative healthcare data for digestive system cancers diagnosed between 2018 and 2021 in Northern Italy, examining diagnostic routes and one-year survival according to pre-existing impairments. Individuals with impairments are more likely to be diagnosed following emergency presentation compared with those without impairments (51.8% compared with 37.9%; adjusted odds ratio 1.41, 95% confidence interval 1.23–1.61), particularly those with impairments of mental and neuromusculoskeletal functions. They also have higher one-year mortality (hazard ratio 1.36, 95% confidence interval 1.26–1.46), independent of socio-demographic and clinical factors. Here, we show that disability-related disparities in emergency cancer diagnosis and survival persist across multiple impairment categories, providing population-based evidence from a European setting on differences in diagnostic pathways across heterogeneous disability groups.