Matched cohort study of cancer-related outcomes in people with a learning disability compared to the general population in the UK

A matched cohort study in the UK was conducted using linked primary care, hospital, mortality, and cancer registry data from Clinical Research Datalink Aurum to compare cancer diagnoses, referrals, and survival among people with a learning disability (LD, also known as intellectual disability) compared to the general population. A total of 180,911 individuals with a LD were matched with 3,405,467 controls. Individuals with a LD had fewer urgent suspected cancer (USC) referrals within 28 days of possible cancer symptoms (aRR 0.52; 95% CI 0.49-0.55). LD was associated with several cancer types as well as cancer before age 50 years (aHR 1.74; 95% CI 1.63-1.86). Absolute incidence was lower in individuals witn a LD compared to those without (1.9% versus 2.0%) due to increased all-cause mortality (aHR 3.19; 95% CI 3.12-3.27). LD was associated with fewer diagnoses via USC referrals (aRR 0.81; 95% CI 0.76-0.86), fewer treatments within six months (0.83; 0.80-0.85) and shorter overall survival (median 4.4 years versus 9.1 years; aHR 1.73; 95% CI 1.65-1.83). The authors conclude that individuals with a LD have higher cancer risk and worse outcomes compared to the general population.