Assessment of cancers’ diagnostic stage in a Deaf community - survey about 4363 Deaf patients recorded in French units

Abstract

BackgroundDeaf people represent 0.1% of the French population and their access to public health campaigns is limited due to their frequent illiteracy and the infrequent use of sign language in campaigns. There is also a lack of general health knowledge in spite of the existence of French Deaf Care Units (UASS). The aim of this study is to assess the average diagnostic stage of cancer in the Deaf Community and discuss deafness as a contributing factor.MethodsFour thousand three hundred sixty-three Deaf patients recorded in five UASS, 80 diagnosed between 2005/01/01 and 2014/12/31 were selected from medical records and/or ICD-10 coding. Data regarding cancers were extracted, grouped by stage and compared to literature. Statistical significance was tested with Fisher’s Exact Test.ResultsEighty patients were selected. Most cancers were diagnosed at advanced stages: of 11 prostate cancers, 46% were locally advanced and 18% were metastatic. (In the general population, this was respectively 3% and 10.4% (p < 0.01)). Of six colorectal cancers, 67% were diagnosed at stage III and 33% at stage IV. (Respectively 20.6% and 26.6% (p = 0.03) in the general population). In contrast, of the 15 breast cancers, 93% were diagnosed at stages T1-T3 that was earlier than in the general population (p = 0.43).ConclusionIn this study, we observed a delay cancer diagnosis among Deaf people. Complicated and/or non-systematic screening procedures for cancers would be involved. Which is most likely the result of many factors (communication, medical knowledge). Increasing UASS coverage and health information campaigns in sign language could assist in earlier cancer diagnosis.

Evaluation of a specialist cognitive clinic for the Deaf community

“…Barriers to accessing healthcare may have been contributory, 26 with delayed cancer diagnosis reported in Deaf patients compared to the hearing population. 27 Improved access to primary care and deaf awareness among GPs might therefore reduce times to referral. Furthermore, those with less education tend to take longer to seek help for cognitive symptoms, 28 and Deaf people have lower average educational attainment compared to their peers due to a historical lack of fully accessible education.…”

Assessing and Providing Culturally Competent Care in Radiation Oncology for Deaf Cancer Patients

“…This study found that deaf patients may present at more advanced stages at time of diagnosis for certain cancers compared with their hearing peers, such as for prostate or colorectal cancer. 9 This was only a small study of 80 patients and included a review of patients in a specific geographic subset, raising the issue of generalizability of these results. Our literature search revealed that there have not been any studies reporting on whether deaf patients are at a disparity in the type of medical or surgical treatment they receive in comparison with their hearing counterparts.…”

“…8 One study was a multi-institutional retrospective review of the diagnostic stages of deaf adults at time of diagnosis. 9 Another study conducted a review of major research databases for literature on the quality and outcomes of health initiatives tailored to improving the knowledge of deaf adults while adhering to national guidelines on cancer treatment and prevention. 10 The rest, 16 in total, were interventional studies designed to assess various educational initiatives in the form of programs, videos, or online modules, and so forth, which were tailored to be accessible to deaf participants.…”

Revisão (a)sistemática sobre a atenção da psicologia às gestantes surdas

“…O número de estudos sobre a saúde geral da população surda é sensivelmente superior às investigações sobre gestantes surdas/com deficiência. No entanto, as considerações são semelhantes a respeito da necessidade de ampliar investigações científicas e censitárias (Barnett et al, 2011;Druel et al, 2018;McKee et al, 2011a;McKee et al, 2011b;Woodcock & Pole, 2007). Considera-se que o desconhecimento da realidade de todas e de cada uma, de suas limitações e potencialidades, fazem com que o preconceito e a rotulação ganhem espaço entre a gestante com deficiência/surda e o contexto ao qual ela está inserida.…”

“…A despeito da saúde da população surda estudos indicam que esta quando comparada à população geral tende a sofrer mais abusos físicos e sexuais pelo parceiro(a) e tentar suicídio (Barnett et al, 2011), sofrer de depressão e abusar de álcool e tabaco (Woodcock & Pole, 2007), apresentar sobrepeso e obesidade (Barnett et al, 2011;Mckee et al, 2011b) e dificuldade para obter informações necessárias à promoção de sua saúde (Anderson, Craig & Ziedonis, 2017;Druel et al, 2018;Mckee et al, 2011a;Mckee et al, 2011b;Mckee et al, 2015;Woodcock & Pole, 2007). Estes estudos sinalizam, portanto, a falta de acesso à informações, importantes e necessárias à promoção de saúde e prevenção de doenças de pessoas surdas.…”