Shocking inequalities experienced by men with learning disabilities when diagnosed with prostate cancer have been highlighted in a study by University of Manchester and Christie NHS Foundation Trust researchers.
Published in the journal European Urology Oncology today (20/02/26), the researchers show men with learning disabilities are 35% more likely than similar aged men without learning disabilities to have prostate cancer symptoms but 34% less likely to have a diagnostic PSA (Prostate-Specific Antigen) test.
The study is funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC). The research team is supported by both the NIHR GM PSRC and the NIHR Manchester Biomedical Research Centre (BRC).
Following an elevated PSA, referrals are 17% less likely, biopsies 46% less likely and prostate cancer diagnoses 49% less likely.
They were almost six times more likely to be diagnosed with prostate cancer on the date of death, 79% more likely to present with metastatic disease at an advanced stage and had a two-fold increased risk of death following diagnosis.
And they were also 61% more likely to have missing Gleason scores, the grading system used to evaluate prostate cancer based on how cancer cells look under a microscope.
However, when prostate cancer was diagnosed at a localised stage and deemed to require treatment, men with learning disabilities received curative therapies at similar rates to those without. This suggests that the benefits of early diagnosis apply equally to this group.
The study population comprised 29,554 men with a learning disability compared to 518,739 men with no recorded diagnosis of a learning disability, linked to hospital, mortality, and cancer registry data.
Lead author Dr Oliver Kennedy a clinical lecturer from The University of Manchester and The Christie NHS Foundation Trust said: "Learning disabilities are increasingly recognised as a hidden driver of cancer mortality. However, evidence on prostate cancer care in this population is limited.
"This study is the first to identify specific points along the prostate cancer diagnostic and treatment pathway that may contribute to poorer outcomes for patients with a learning disability."
And co-author Professor Darren Ashcroft, director of the NIHR Greater Manchester PSRC and professor at The University of Manchester, said: "Learning - or intellectual - disability is a lifelong neurodevelopmental condition characterised by significant impairments in intellectual functioning and adaptive behaviour, with onset in childhood.
"In the UK, 1.5 million people have a learning disability. This group frequently encounters barriers within healthcare services, including communication difficulties, not doing enough to remove barriers, and the overshadowing of new symptoms on existing health conditions.
"Men with a learning disability face disparities across the prostate cancer care pathway, from investigation of relevant symptoms to survival after diagnosis. Targeted interventions are needed to address these inequities."
Dr Kennedy added: "Addressing these health disparities has been recognised as a priority by the NHS Long Term Plan, National Institute for Health and Care Excellence guidance, and the Learning from Lives and Deaths programme in England.
"We hope our study provides strong evidence that prostate cancer should be part of that conversation
Jon Sparkes OBE, Chief Executive of learning disability charity Mencap, said: "Too many men with a learning disability are being let down by a health system that doesn't spot their cancers early enough or support them to navigate complex treatments.
"This important research into what is now the most commonly diagnosed cancer in the UK should be a wake-up call: with the right reasonable adjustments, accessible information and specialist support, these inequalities are not inevitable.
"Through Mencap's I'm In campaign we're working with health partners across the UK to get more people on the Learning Disability Register. Being on the register means they'll receive free annual health checks and support in the way they need it, so health problems can be spotted and treated earlier.
"But we can't do this alone. We need the NHS, government and cancer services to join us in making inclusive health a priority - acting on this evidence and putting the right support in place at every stage of the cancer pathway."
Natalia Norori, Head of Data & Evidence at Prostate Cancer UK, said: "The results of this paper are deeply concerning. It sheds light on the stark inequalities men with learning disabilities face at every stage of the pathway - from diagnosis, to treatment and even death.
"This issue goes beyond prostate cancer, but by understanding the impact of these inequalities in the most common cancer in the UK, we can begin to tackle it.
"More work now needs to be done to understand more about why these men are facing so many obstacles to accessing care and how to prevent them. That's why Prostate Cancer UK's TRANSFORM screening trial has been specifically designed to evaluate the impact of screening in all men, including those with learning disabilities, to ensure no man is left behind."
- The paper Prostate Cancer Care in Men with an Intellectual Disability: A Population-Based Cohort Study of Symptoms, Diagnosis, Treatment and Survival is available here DOI : https://doi.org/10.1016/j.euo.2026.01.004
