Men with learning difficulties (LD) are four times more likely to die of testicular cancer than the general population, according to a new UK study presented at the European Association of Urology (EAU) conference in London.
The study found that LD men with testicular cancer have a one in 10 chance of dying from the disease, compared to a one in 36 chance in the general population. Since the study is the first to look at cancer survival rates in people with learning difficulties, the authors are still unsure whether this increased mortality rate applies to all cancers or just to testicular cancer.
Research has shown that men with intellectual disabilities die on average 13 years earlier than the general population. In females, the situation is even worse, as women with intellectual difficulties die on average 20 years earlier. Most of these deaths are believed to be due to cardiovascular disease, but now a group of UK scientists and clinicians investigated testicular cancer incidence and how it relates to learning difficulties.
For the study, researchers at the University of Birmingham in England identified 158,138 male patients with learning difficulties from the National Health Service (NHS) Hospital Episode Statistics database.
During a 14-year period from 2001 to 2015, they found that 331 of these men had been diagnosed with testicular cancer and 32 had died from it. In the general population, 25,675 had testicular cancer with 713 cancer specific deaths, meaning that the rate of cancer deaths was significantly higher in people with learning difficulties.
“We found that people with learning disabilities are not only more likely to develop testicular cancer, but are also far more likely to die from it than the general population,” said lead author Dr. Mehran Afshar at St. George’s Hospital, London.
“Testicular cancer is relatively rare, but if similar imbalances apply to all cancers, which we suspect to be the case, this would make excess cancer deaths associated with learning difficulties a significant public health issue. However, we don’t yet have any statistics to confirm this. We are still processing the data on other cancers, such as prostate, breast, and colorectal cancer.”
“We propose that there might be several reasons which cause this disparity in survival, perhaps including the possibility that men with learning difficulties are not so good at self-examination, going to the doctor, and then following through with any treatment. It could also be that because consent is more difficult to obtain from these patients it affects the treatment they receive.”
Although cure rates for testicular cancer are high, it is still the third leading cause of cancer death among men aged 18 to 50. Overall, cancers are less common in patients with learning difficulties, although this is changing as LD patients are generally living longer.
“This study is important because it identifies a vulnerable group of patients at increased risk of cancer mortality. As health care professionals we will need to develop methods to provide better health care focused specifically on people with intellectual disabilities,” said Professor Jens Sønksen (University of Copenhagen) of the EAU Scientific Congress Committee.
Source: European Association of Eurology