Table of Contents
Lung Cancer International
Volume 2016, Article ID 6787648, 7 pages
http://dx.doi.org/10.1155/2016/6787648
Review Article

Challenges in Diagnosis and Treatment of Lung Cancer in People with Intellectual Disabilities: Current State of Knowledge

1Oncodéfi, Parc Euromédecine, 209 avenue des Apothicaires, Parc Euromédecine, 34 090 Montpellier, France
2Team Biostatistics Epidemiology Public Health, EA 2415, University Institute for Clinical Research, 34 093 Montpellier, France
3Medical Oncology Department, Hôpital Henri Mondor, AP-HP, 51 avenue du Maréchal de Lattre de Tassigny, 94 010 Créteil, France
4Pierre et Marie Curie University, Paris, France
5Radiotherapy Service, Institut de Cancérologie Val d’Aurelle, Parc Euromédecine, 208 avenue des Apothicaires, 34 298 Montpellier, France
6Department of Fundamental Health Sciences, Health Sciences University of Hokkaido, Tobetsu, Hokkaido 061-0293, Japan
7Descartes University, Paris, France
8Unit of Thoracic Oncology Service, Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014 Paris, France

Received 29 March 2016; Revised 17 June 2016; Accepted 4 September 2016

Academic Editor: Natasha B. Leighl

Copyright © 2016 Daniel Satgé et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

As the life expectancy of people with intellectual disability (ID) has progressed, they have become similarly at risk of cancer as individuals of the general population. Epidemiological studies indicate a reduced incidence and mortality from lung cancer in the total population of persons with ID. However, the pattern is heterogeneous and the risk is strongly correlated with the impairment level; persons with mild intellectual impairment have higher cancer risk, and this subgroup also has the highest tobacco consumption (the major risk factor for lung cancer) compared to individuals with more severe impairment. Clinical presentation of lung cancer in persons with ID is often atypical, with symptoms frequently hidden by the mental state and communication impairments. Treatment can be impeded by incomplete understanding and lack of cooperation on the part of the patient; nevertheless, general principles for treating lung cancer must be applied to persons with ID. Early diagnosis and implementation of an adapted treatment plan may result in lung cancer outcomes similar to those of individuals in the general population. Physicians facing the difficult task of treating lung cancer in persons with ID are called to carry out their mission of care in a responsible, free, and creative way.