The Introduction of Cancer Screening Within an Enhanced Physical Health Clinic for People With Intellectual Disabilities and Mental Health Difficulties

Abstract

People with intellectual disabilities (ID), particularly those with co-existing mental health difficulties, experience health inequalities and premature mortality. Cancer is a prominent cause of mortality, partially due to the difficulties this population faces in accessing screening. This paper explores the rates of colorectal, breast, cervical and prostate screening over a 28-month period within an Enhanced Physical Health Clinic (EPHC) set within a specialist ID psychiatry service in Essex, United Kingdom (UK). We examined completion of, and any barriers to screening among EPHC patients (n = 463), and compared this to population-wide screening data in the UK among people with an ID. The EPHC facilitated support with screening by providing reasonable adjustments, including providing easy-read leaflets or booking appointments. The number of patients eligible for screening was colorectal (n = 83), breast (n = 73), cervical (n = 120) and prostate (n = 50), respectively. In comparison to the population-wide data available for people with ID, successful screening by EPHC patients was significantly higher for colorectal (93% vs. 78%), breast (74% vs. 53%) and cervical screening (40% vs. 31%). While there is no national prostate screening programme to generate comparison figures, 98% of those eligible accessed screening through the EPHC. These results suggest that the EPHC, which operates within a specialist ID psychiatry service in secondary care, is an innovation that may help improve cancer screening rates.