Cancer incidence and mortality among adults with disabilities in Korea: A 15-year study
Abstract
Background: Despite precision medicine’s growth, 15% of the global population with disabilities remains in a “clinical blind spot.” While previous research focused on fragmented metrics, this study investigates the “Incidence Paradox”—where lower adjusted cancer incidence masks systemic healthcare exclusion—to provide evidence for precision public health policies aimed at clinical equity and addressing systemic neglect.
Methods: This nationwide serial cross-sectional study (2008–2022) linked the National Health Information Database (NHID) and the National Disability Registration Database (NDRD), covering 43,403,837 adults. Age-standardized rates (ASR) were calculated for the 2015 Korean population. Multivariate logistic regression estimated adjusted odds ratios (aOR) for cancer prevalence, incidence, and mortality, controlling for age, sex, income, residence, and Charlson Comorbidity Index (CCI).
Results: In 2022, age-standardized prevalence was higher in the disabled (4,704.3 per 100,000) than the non-disabled (3,981.3). However, an “Incidence Paradox” emerged: adjusted risk of new cancer diagnosis was significantly lower for people with disabilities (Male aOR, 0.70; Female aOR, 0.57). This reflects systemic under-diagnosis, validated by mortality data: post diagnosed, individuals with disabilities faced significantly higher mortality risks (Male aOR: 1.34; Female aOR: 1.96). Notably, men with intellectual/psychological disabilities and women with brain injuries faced 2.08- and 2.07-fold higher mortality, marking the worst survival inequalities.
Conclusions: The gap between low diagnosis and high mortality signifies structural failure in the cancer continuum. Lower incidence is a grave warning of healthcare exclusion, not success. Strategies must shift to disability-specific integrated management and enhanced accessibility to both medical institutions and diagnostic equipment. This study is a critical milestone for bridging the lethal survival gap.
Key messages: • Low cancer incidence in the disabled reflects diagnostic barriers rather than lower risk, leading to higher mortality. This paradox highlights urgent needs for early detection and accessibility.
• Extreme gaps—notably 2.08-fold for intellectual/psychological disabled men and 2.07-fold for brain-injured women—demand disability-specific management and accessibility.
Related
- Sex differences in gastrointestinal cancers incidence and mortality among adolescents and young adults in China: an age-period-birth cohort study
- Socio-economic inequalities and cancer mortality among adolescents and young adults between 2000 and 2023
- Incidence, Prevalence, Mortality, and Disability‐Adjusted Life Years Due to Cancer Among Adolescents Aged 10–19 Years in Iran, 1990–2023: A Trend Analysis of the Global Burden of Disease Study
- Association of physical activity with all-cause, cardiovascular, and cancer mortality among adults with diabetes: Mexico City Prospective Study
- Associations of anthropometric indices with all-cause and cause-specific mortality among US adults with a self-reported history of cancer: a population-based cohort study.
BibTeX
@article{lee2026cancer,
title = {{Cancer incidence and mortality among adults with disabilities in Korea: A 15-year study}},
author = {U Lee and S Kim and B Park and J Park},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1456},
url = {https://doi.org/10.1093/eurpub/ckag169.1456},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Cancer incidence and mortality among adults with disabilities in Korea: A 15-year study
AU - U Lee
AU - S Kim
AU - B Park
AU - J Park
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1456
UR - https://doi.org/10.1093/eurpub/ckag169.1456
AB - Background: Despite precision medicine’s growth, 15% of the global population with disabilities remains in a “clinical blind spot.” While previous research focused on fragmented metrics, this study investigates the “Incidence Paradox”—where lower adjusted cancer incidence masks systemic healthcare exclusion—to provide evidence for precision public health policies aimed at clinical equity and addressing systemic neglect. Methods: This nationwide serial cross-sectional study (2008–2022) linked the National Health Information Database (NHID) and the National Disability Registration Database (NDRD), covering 43,403,837 adults. Age-standardized rates (ASR) were calculated for the 2015 Korean population. Multivariate logistic regression estimated adjusted odds ratios (aOR) for cancer prevalence, incidence, and mortality, controlling for age, sex, income, residence, and Charlson Comorbidity Index (CCI). Results: In 2022, age-standardized prevalence was higher in the disabled (4,704.3 per 100,000) than the non-disabled (3,981.3). However, an “Incidence Paradox” emerged: adjusted risk of new cancer diagnosis was significantly lower for people with disabilities (Male aOR, 0.70; Female aOR, 0.57). This reflects systemic under-diagnosis, validated by mortality data: post diagnosed, individuals with disabilities faced significantly higher mortality risks (Male aOR: 1.34; Female aOR: 1.96). Notably, men with intellectual/psychological disabilities and women with brain injuries faced 2.08- and 2.07-fold higher mortality, marking the worst survival inequalities. Conclusions: The gap between low diagnosis and high mortality signifies structural failure in the cancer continuum. Lower incidence is a grave warning of healthcare exclusion, not success. Strategies must shift to disability-specific integrated management and enhanced accessibility to both medical institutions and diagnostic equipment. This study is a critical milestone for bridging the lethal survival gap. Key messages: • Low cancer incidence in the disabled reflects diagnostic barriers rather than lower risk, leading to higher mortality. This paradox highlights urgent needs for early detection and accessibility. • Extreme gaps—notably 2.08-fold for intellectual/psychological disabled men and 2.07-fold for brain-injured women—demand disability-specific management and accessibility.
SN - 1101-1262
SN - 1464-360X
ER -