A large-scale study has found that women with disabilities are significantly more likely to be diagnosed with breast cancer at later stages and face substantially higher mortality rates—even after surgery—compared with non-disabled patients.
The findings come from a joint research team led by Professor Shin Dong-wook and Professor Choi Hye-rim of Samsung Seoul Hospital’s Cancer Patient Quality of Life Research Institute, along with Professor Han Kyung-do of Soongsil University’s Department of Information Statistics, Insurance and Mathematics. Their analysis was published in the latest issue of the international medical journal JAMA Network Open.
The team examined medical data from 154,412 women diagnosed with breast cancer between 2012 and 2019. Among them, 7,443 patients had registered disabilities. The researchers identified clear disparities beginning at the point of diagnosis.
Patients with severe disabilities were more likely to be diagnosed at an advanced stage. In this group, 6.3% had cancer that had already spread to other organs at the time of diagnosis—about 1.34 times higher than the rate among non-disabled patients (4.7%).
Significant gaps were also found in access to treatment. Compared with non-disabled patients, those with severe disabilities were 19% less likely to undergo surgery. They were also 34% less likely to receive chemotherapy and 35% less likely to receive radiation therapy.
The disparity was particularly pronounced among patients with severe brain lesion disorders, who received chemotherapy at only 42% of the rate seen in non-disabled patients. The researchers suggested that practical barriers—such as limited mobility and the need for frequent hospital visits for chemotherapy and radiation—may contribute to these treatment gaps.
These differences in diagnosis and treatment translated into stark contrasts in survival outcomes. Even among patients who were diagnosed early and underwent surgery, those with severe disabilities faced a 3.16 times higher risk of death from breast cancer compared with non-disabled patients.
The team also noted that long-term care issues, including postoperative management and medication adherence, may further widen survival gaps for breast cancer patients with disabilities.
“The treatment disparities revealed in this study go beyond simple differences in healthcare utilization,” said Professor Choi Hye-rim, the study’s first author. “They show that patients face distinct barriers depending on the type and severity of their disability. A tailored medical support system that reflects these differences is urgently needed.”
Professor Shin Dong-wook, the corresponding author, added, “Although outcomes for breast cancer treatment are improving overall, gaps in diagnosis and care continue to drive survival differences based on disability status. Institutional measures are needed to improve access to cancer treatment for patients with disabilities.”
The researchers emphasized that addressing these disparities will require systemic changes to ensure equitable cancer screening, treatment access, and long-term care for people living with disabilities.
