Primary Care Providers’ Attitudes and Experiences Recommending Cancer Screening to Individuals with Intellectual Disabilities

Genevieve Breau, Interdisciplinary Oncology Program, Faculty of Medicine, University of British Columbia
Coach House, Green College, UBC 
Monday, April 4, 8-9:00 pm
in the series
Resident Members' Series

People with Intellectual Disabilities have significantly lower breast, cervical, and colorectal cancer screening rates, relative to the general population. The reasons for these disparities are poorly understood. In the general population, one predictor of receipt of cancer screening is a recommendation by a patient’s primary care provider, usually a family physician. Health care providers may also have negative attitudes towards people with Intellectual Disabilities, and these attitudes may influence their provision of care, including whether providers recommend cancer screening.

In her PhD dissertation, Genevieve surveyed family physicians, family practice residents, and nurse practitioner students regarding their attitudes towards people with Intellectual Disabilities, and asked them to rate the likelihood they would recommend cancer screening to fictional patients with Intellectual Disabilities presented in written vignettes. She also interviewed a subsample of physicians and residents regarding their experiences in promoting cancer screening, both to their patients with Intellectual Disabilities and to all patients in their practice.

Genevieve identified one component of attitudes, believing that people with Intellectual Disabilities should be included in community life, predicted anticipated likelihood of recommending cancer screening to fictional patients. She also discovered that participants consider multiple factors, including both applying evidence-based guidelines and exercising clinical judgement, when deciding to recommend cancer screening to any given patient. These results demonstrate that further research is needed to determine if aspects of attitudes, and physicians’ method of balancing competing demands in a clinical setting, occur in other clinician groups and in other care contexts.