癌症是智力或发育障碍 (IDD) 患者死亡的主要原因。尽管研究表明癌症筛查率较低，但量化潜在诊断延迟的流行病学证据有限。本研究探讨了加拿大乳腺癌（女性）、结直肠癌和肺癌患者中 IDD 患者与非 IDD 患者相比，罹患转移性癌症阶段的风险。在安大略省和曼尼托巴省进行了单独的基于人群的横断面研究，通过常规联系收集的数据。乳腺癌（女性）、结直肠癌和肺癌患者均纳入其中（马尼托巴省：2004-2017 年；安大略省：2007-2019 年）。 IDD 状态是使用既定的管理算法来识别的。使用稳健误差方差模型的修正泊松回归估计了 IDD 状态与被诊断患有转移性癌症的可能性之间的关联。使用随机效应荟萃分析，汇总各省之间调整后的相对风险。考虑了潜在的效果修改。最终队列分别包括 115,456、89,815 和 101,811 名乳腺癌（女性）、结直肠癌和肺癌患者。与无 IDD 的乳腺癌（女性）和结直肠癌患者相比，患有 IDD 的乳腺癌（女性）和结直肠癌患者在诊断时罹患转移性癌症（IV 期）的可能性分别高出 1.60 倍和 1.44 倍（相对风险 [RR]，1.60；95% 置信区间 [CI]，1.16） -2.20；RR，1.44；95% CI，1.24-1.67）。在肺癌中没有观察到这种风险增加。没有观察到显着的效果改变。与没有 IDD 的人相比，患有 IDD 的人在诊断时更有可能患有 IV 期乳腺癌和结直肠癌。确定导致阶段差异的因素和流程（例如较低的筛查率）并制定解决诊断延迟的策略至关重要。© 2023 作者。 《癌症》由 Wiley periodicals LLC 代表美国癌症协会出版。

Cancer is a leading cause of death among people living with intellectual or developmental disabilities (IDD). Although studies have documented lower cancer screening rates, there is limited epidemiological evidence quantifying potential diagnostic delays. This study explores the risk of metastatic cancer stage for people with IDD compared to those without IDD among breast (female), colorectal, and lung cancer patients in Canada.Separate population-based cross-sectional studies were conducted in Ontario and Manitoba by linking routinely collected data. Breast (female), colorectal, and lung cancer patients were included (Manitoba: 2004-2017; Ontario: 2007-2019). IDD status was identified using established administrative algorithms. Modified Poisson regression with robust error variance models estimated associations between IDD status and the likelihood of being diagnosed with metastatic cancer. Adjusted relative risks were pooled between provinces using random-effects meta-analyses. Potential effect modification was considered.The final cohorts included 115,456, 89,815, and 101,811 breast (female), colorectal, and lung cancer patients, respectively. Breast (female) and colorectal cancer patients with IDD were 1.60 and 1.44 times more likely to have metastatic cancer (stage IV) at diagnosis compared to those without IDD (relative risk [RR], 1.60; 95% confidence interval [CI], 1.16-2.20; RR, 1.44; 95% CI, 1.24-1.67). This increased risk was not observed in lung cancer. Significant effect modification was not observed.People with IDD were more likely to have stage IV breast and colorectal cancer identified at diagnosis compared to those without IDD. Identifying factors and processes contributing to stage disparities such as lower screening rates and developing strategies to address diagnostic delays is critical.© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.