Background: The development of the Optimal Care Pathway (OCP) for People with Disability aims to inform how best cancer care can be achieved, reducing inequities and improving cancer outcomes. Approximately 5.5 million people have disability in Australia, representing 21% of the population. People with disability experience inequities throughout cancer care, including higher exposure to modifiable risk factors, lower screening participation, increased barriers to timely diagnosis and treatment, and higher cancer-related mortality. Understanding the current evidence on optimal cancer care for people with disability is essential to ensuring the OCP integrates research with clinical expertise and lived experience.
Methods: As per the National Optimal Care Pathways Framework, an iterative literature review was undertaken. Searches were conducted using Google Scholar, supplemented by citation tracking and targeted searches for evidence gaps. Studies were included if they examined people with pre-existing disability and reported findings relevant to the OCP, prioritising Australian literature. Evidence was synthesised and mapped to OCP steps and principles to identify barriers, enablers and recommendations across the cancer care continuum.
Results: The review identified inequities across all stages of cancer care, including reduced participation in screening, delays in diagnosis, barriers to treatment access, limited healthcare professional capability, inadequate provision of reasonable adjustments, poorer care experiences and worse health outcomes. However, the available evidence was highly variable across disability populations, with most research focusing on selected disability groups, and evidence on many disability types remaining sparse or absent.
Conclusions: This review highlights that the evidence base informing cancer care for people with disability remains limited and uneven across disability populations and the cancer care continuum. Integrating evidence with lived experience and current examples of best practice is essential to informing optimal care for people with disability. Further research is needed to address evidence gaps and strengthen the foundation for equitable care.