Cancer diagnosis communication and mental health in mild intellectual disability
Keywords:
communication; oncology; cancer; diagnosis; mental healthAbstract
Introduction: Cancer presents a growing challenge in healthcare, especially in vulnerable populations such as people with intellectual disabilities. Diagnostic communication in oncology is a determining factor for mental health and shared decision-making. The aim of this systematic review is to identify theoretical approaches to the influence of communication on cancer patients with mild intellectual disabilities.
Method: A systematic review was conducted following the PRISMA 2020 guidelines and applying the CASP checklists. Studies published between 2008 and 2024, identified in multiple international databases, were included. Articles addressing diagnostic communication in oncology and its impact on mental health and participation in decision-making were analyzed. This work is part of the project Development of Effective Communication between Healthcare Workers and Patients, of the Center for the Development of Social and Humanistic Sciences in Health.
Results: The reviewed studies found that adapted communication, family support, and the integration of the biopsychosocial model act as protective factors against the emotional impact of cancer. However, specific evidence regarding mild intellectual disability is scarce and has methodological limitations, which restricts the generalizability of the findings.
Discussion: The results underscore the need for inclusive strategies that incorporate clear language, visual resources, and caregiver support. More rigorous research is required to strengthen scientific validity and guide health policies toward more inclusive, person-centered cancer care.
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References
1. Pan American Health Organization. [Internet] Washington, DC: PAHO; [actualized 2023; cited 10/11/2025] Cancer in the Americas: situation and trends. Available in: https://www.paho.org/en/documents/cancer-americas-situation-and-trends
2. World Health Organization. [Internet]. Geneva: WHO; [actualized 2023; cited 10/11/2025] Cancer fact sheet. Available in: https://www.who.int/news-room/fact-sheets/detail/cancer
3. Ministerio de Salud Pública. [Internet]. La Habana: MINSAP; [actualizado 2024; citado 10/11/2025] Anuario Estadístico de Salud 2023.
Disponible en: https://files.sld.cu/dne/files/2024/09/Anuario-Estad%c3%adstico-de-Salud-2023-EDICION-2024.pdf
4. Bray F, Laversanne M, Weiderpass E, Soerjomataram I. Cancer as a leading cause of premature death worldwide. Cancer [Internet]. 2021[cited 10/11/2025];127(16):3029–3030. Available in: https://doi:10.1002/cncr.33587
5. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES protocol for delivering bad news. Oncologist. [Internet]. 2000 [cited 10/11/2025];5(4):302–311.
Available in: https://doi:10.1634/theoncologist.5-4-302
6. Engel GL. The need for a new medical model: a challenge for biomedicine. Science. [Internet]. 1977 [cited 10/11/2025];196(4286):129–136. Available in: https://doi:10.1126/science.847460
7. Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet. [Internet]. 2004 [cited 10/11/2025];363(9405):312–319. Available in: https://doi:10.1016/S0140-6736(03)15392-5
8. Kissane DW, Bultz BD, Butow PN, Bylund CL, Noble S, Wilkinson S.
Communication in cancer care: psycho-oncology’s contribution. Psychooncology. [Internet]. 2012 [cited 10/11/2025];21(4):369–377.
Available in: https://revistas.ucm.es/index.php/PSIC/article/view/59192/4564456546600
9. Baile WF, Aaron J. Patient-physician communication in oncology: past, present, and future. Curr Opin Oncol. [Internet]. 2005 [cited 10/11/2025];17(4):331–335.
Available in: https://doi:10.1097/01.cco.0000167738.49325.2c
10. Northouse L, Williams AL, Given B, McCorkle R. Psychosocial care for family caregivers of patients with cancer. J Clin Oncol. [Internet]. 2012 [cited 10/11/2025];30(11):1227–1234. Available in: https://doi:10.1200/JCO.2011.39.5798
11. Liu Y, Yang J. Huo D, Fan H, Gao Y. Disclosure of cancer diagnosis in China: the incidence, patients’ situation, and different preferences between patients and their family members and related influence factors. Cancer Management and Research. [Internet]. 2018 [cited 10/11/2025]; 10: 2173–2181.
Available in: https://doi.org/10.2147/CMAR.S166437
12. Tuffrey-Wijne I, Hollins S. Preventing ‘deaths by indifference’: identification of reasonable adjustments is key. British Journal of Psychiatry. [Internet].2014[cited 10/11/2025];205(2):86-87. Available in: https://doi:10.1192/bjp.bp.113.142299
13. Page MJ, McKenzie JE, Bossuyt PM, Isabelle Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. [Internet]. 2021[cited 10/11/2025];372:n71. Available in: https://doi:10.1136/bmj.n71
14. Epstein RM, Street RL. Patient-centered communication in cancer care: promoting healing and reducing suffering. Bethesda: National Cancer Institute. [Internet].2007[cited 10/11/2025] 07-6225.
Available in: https://cancercontrol.cancer.gov/sites/default/files/2020-06/pcc_monograph.pdf
15. Bensing J, Verhaak P, van Dulmen S, Visser A. Communication: the royal pathway to patient-centered medicin. Patient Educ Couns. [Internet].2000 [cited 10/11/2025];39(1):1–6. Available in: http://hdl.handle.net/1874/21887
16. Pfizer. [Internet] España Madrid: Pfizer; [actualized 2024; cited 10/11/2025] Guía sobre cáncer para personas con discapacidad intelectual.
17. Alcañiz Rodríguez M. Impacto psicológico, rasgos de personalidad y mecanismos de afrontamiento en pacientes oncológicos. Psicooncología. [Internet] 2018. [citado 10/11/2025];15(1):7–18.
Disponible en: https://repositorio.uam.es/server/api/core/bitstreams/57002098-8636-4f8a-9d83-b49410e3b433/content
18. Glasdam S, Cohen M, Soffer M, Fu C. Experiences and strategies of individuals with concomitant intellectual disabilities and cancer: a qualitative systematic literature review. Front Cancer Control Soc [Internet]. 2025 [cited 2025 Oct 11];3:1659795. Available from: https://doi.org/10.3389/fcacs.2025.1659795
19. Williams AM, Paterson C, Heckler Ch, Barton D, OntkoM, Geer J, et al. Fatigue, anxiety and quality of life in breast cancer patients compared to non-cancer controls. Breast Cancer Res Treat. [Internet] 2021[cited 10/11/2025];186(2):519–529.
Available in: https://link.springer.com/article/10.1007/s10549-020-06067-6
20. Heidenreich A, Elsner S, Wörler F, Hübner J, Schües C, Rehmann-Sutter C, et al. Physicians’ perspectives on family caregivers’ roles in elderly cancer patients’ therapies: a qualitative study. Support Care Cancer. 2023;31(7):387. doi:10.1007/s00520-023-07857-6
21. Castro Osorio R, Arce Rodríguez L, Navarrete Pinzón A, Paula Pérez-Camero P, Martínez-Castillo J. Prácticas clínicas de comunicación del diagnóstico en oncología pediátrica. Papeles del Psicólogo. [Internet]. 2023[citado 10/11/2025];44(1):1–12.
Disponible en: https://scielo.isciii.es/scielo.php?pid=S0214-78232022000200006&script=sci_arttext
22. Llerenas Á, Domínguez-Esponda R, Katz-Guss G, Astudillo-García CI, Rodríguez-Valentín R, Madrigal-de León E, et al. Comunicación abierta entre profesionales de salud mental y padres de pacientes con discapacidad intelectual. Rev Salud Mental. [Internet] 2022 [citado 10/11/2025];45(3):123–132.
Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=95381
23. Fando CE, Reyes PA, Arteche HLL, Hernández LY. Comunicación de la verdad en oncología desde la visión bioética médica. Rev Cubana Bioética. [Internet] 2017 [citado 10/11/2025];15(2):45–56.
Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=119602
24. Ordóñez Vázquez J, Monroy Nasr, Z. Comunicación médico-paciente en enfermos de cáncer en etapa terminal. Rev Mex Oncol. [Internet] 2021 [citado 10/11/2025];20(4):233–240. Disponible en: https://revistas.umng.edu.co/index.php/rlbi/article/view/4837
25. Huertas Sánchez ÁA. La comunicación al diagnóstico con el enfermo oncológico terminal. Rev Mex Psicooncología. [Internet] 2023[citado 10/11/2025];13(1):45–56.
Disponible en: https://titula.universidadeuropea.com/handle/20.500.12880/5869
26. Villoria E, Lara L, Salcedo R. Estado emocional de pacientes oncológicos. Rev Med Chile. [Internet] 2021[citado 10/11/2025];149(3):345–353.
Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872021000500708&lng=es.
27. Maldonado-Castillo S, Santa-Cruz-Espinoza H. Estigma y salud mental en pacientes con diagnóstico de cáncer. Rev Peru Med Exp Salud Publica. [Internet] 2024 [citado 10/11/2025];41(1):56–64.
Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412024000100005&lng=es
28. Boonman AJ, Cuypers M, Naaldenberg J, Leusink GL, Bloemendal HJ. Cancer treatment and decision making in individuals with intellectual disabilities: a scoping literature review. Lancet Oncol [Internet]. 2022 Apr [cited 2025 Oct 11];23(4):e174–e183. Available in: https://doi.org/10.1016/S1470-2045(21)00694-X
29. Hernández M, Cruzado Rodríguez JA, Prado C, Rodríguez E, Hernández Pascual C, González Torres MÁ, et al. Salud mental y malestar emocional en pacientes con cáncer. Psicooncología. [Internet] 2012[citado 10/11/2025];9(2–3):345–356.
Disponible en: https://produccioncientifica.ucm.es/documentos/5d399a0f299952068445d322
30. Cuypers M, Cairns D, Robb KA. Research priorities to improve cancer care for people with intellectual disabilities across the cancer continuum. BMJ Oncol [Internet]. 2024 [cited 2025 Oct 11];3:e000395. Available in: https://doi.org/10.1136/bmjonc-2024-000395
31. Wang Y, Seplaki ChL, Norton SA, Williams AL, Kadambi S, Poh K. Communication between caregivers and professionals in oncology. Curr Oncol Rep. [Internet] 2024[cited 10/11/2025];26(3):345–356.
Available in: https://link.springer.com/article/10.1007/s11912-024-01550-5
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Copyright (c) 1970 Lina Adriana Arzuaga Anderson, Gustavo de Jesús Crespo Campos, Clay Pérez Jiménez
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