The benefits and harms of cancer screening programmes for adults with intellectual disabilities: A systematic review

Abstract

Introduction Cancer screening programmes are an important public health initiative aimed at reducing morbidity and mortality through the early detection of breast, cervical, and colorectal cancers. The available evidence points towards lower screening participation in cancer screening programmes among people with intellectual disabilities, but the balance of benefits and harms of screening is unknown. The aim of this systematic review is to examine the health outcomes (mortality, morbidity) and harms of cancer screening programmes for adults with intellectual disabilities.

Materials and methods The review is registered on the Open Science Framework Registries: https://osf.io/8vmkb. A systematic search of published peer-reviewed and grey literature was conducted from inception up to 28th February 2025. MEDLINE, EMBASE, Web of Science, PsycINFO, and relevant organisational websites were searched. Additionally, experts in the field were consulted about evidence on the health outcomes and harms of national cancer screening programmes for adults with intellectual disabilities. Two reviewers independently screened titles and abstracts and assessed full texts against the eligibility criteria.

Results A total of 3,104 records were identified, and 232 full-text articles were assessed for eligibility. No study met the inclusion criteria.

Conclusions There is a critical lack of evidence regarding the benefits and harms of cancer screening programmes for people with intellectual disabilities. There are numerous studies relating to coverage, uptake, and factors influencing participation in cancer screening programmes. Participation should not be assumed to equate to better outcomes, and there is a real risk of ‘equity-washing’ if this is used as a basis for practice. There is, therefore, an urgent need to examine the full screening pathway continuum for people with intellectual disabilities, along with the associated outcomes, benefits, and harms.