{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T20:48:52Z","timestamp":1767646132930,"version":"3.48.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Melbourne Disability Institute","award":["Postdoctoral Fellowship"],"award-info":[{"award-number":["Postdoctoral Fellowship"]}]}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer is a major yet under-recognised contributor to the mortality gap between people with and without disability. Our study aims to quantify these inequalities to inform cancer control efforts to reduce the gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>We used nationally-linked data (2011\u20132022) to construct a cohort of over 10 million adults in Australia aged 25\u201374 years. Disability was measured in 2011 Census as requiring assistance in core daily activities and cancer related deaths identified in national death registrations. We estimated age-standardised and age-specific cancer mortality rates, and absolute and relative mortality inequalities (rate differences and ratios) between people with and without disability. The study included 10,414,951 people. Of the 5,403,503 females, 185,801 (3.4%) reported disability; 183,594 of the 5,011,448 males (3.7%) reported disability. Over 93,940,222 person-years (9.2 years on average), 219,257 cancer-related deaths occurred. After age-standardisation, per 100,000 person-years, there were 314 (95% confidence intervals [CI]: 301, 328) more cancer related deaths in females and 410 (95% CI: 394, 427) more in males with disability (1.96 [95% CI: 1.92, 2.00], and 1.83 [95% CI: 1.80, 1.87] times higher, respectively) than those without disability. The largest absolute inequalities were for lung cancer in both females and males (67 [95% CI: 60, 73] and 103 [95% CI: 95, 111] more deaths per 100,000 person-years, respectively), followed by breast cancer in females (54 [95% CI: 49, 60] more deaths), prostate cancer in males (31 [95% CI: 26, 36] more deaths), and colorectal cancer in both sexes (30 more [95% CI: 25, 34] deaths in females and 44 [95% CI: 38, 49] more in males). By 5-year age group, lung cancer was the leading contributor to absolute inequalities in females and males aged 35 years and older. In females, across most age groups, breast cancer was the second largest contributor to absolute inequalities, followed by colorectal cancer. In males, colorectal cancer was the second largest contributor across most age groups, with prostate cancer contributing substantially to absolute inequalities in those aged 55 years and older. A substantial proportion of differences in cancer-related deaths between people with and without disability, across most age groups in both females and males were driven by cancers linked to smoking, obesity, and alcohol consumption. We found similar-sized relative inequalities between individuals with and without disability in mortality due to individual cancers in both sexes. The main limitation of the study was that disability status was measured at a single time point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>People with disability had higher cancer mortality overall and in relation to specific cancers than people without disability. To close the gap, effort should prioritise interventions that work for people with disability across the cancer control pathway.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pmed.1004873","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T18:25:29Z","timestamp":1767637529000},"page":"e1004873","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inequalities in cancer mortality between people with and without disability: A nationwide data linkage study of 10 million adults in Australia"],"prefix":"10.1371","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7594-6373","authenticated-orcid":true,"given":"Yi","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5587-9540","authenticated-orcid":true,"given":"Nina","family":"Afshar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Aitken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0448-9125","authenticated-orcid":true,"given":"Rebecca J.","family":"Bergin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7211-1891","authenticated-orcid":true,"given":"Peter","family":"Summers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5764-7268","authenticated-orcid":true,"given":"Roger L.","family":"Milne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2962-8400","authenticated-orcid":true,"given":"Sue M.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-3464","authenticated-orcid":true,"given":"Anne","family":"Kavanagh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Disney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"issue":"1","key":"pmed.1004873.ref001","doi-asserted-by":"crossref","DOI":"10.1016\/S1470-2045(24)00405-4","article-title":"The changing global landscape of national cancer control plans","volume":"26","author":"Y Romero","year":"2025","journal-title":"Lancet Oncol"},{"key":"pmed.1004873.ref002","author":"Cancer Australia","year":"2023"},{"key":"pmed.1004873.ref003","unstructured":"World Health Organization (WHO). 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Person Level Integrated Data Asset (PLIDA). 2023. [cited 2024 Aug 28]. Available from: https:\/\/www.abs.gov.au\/about\/data-services\/data-integration\/integrated-data\/person-level-integrated-data-asset-plida"},{"key":"pmed.1004873.ref011","author":"Australian Bureau of Statistics (ABS)","year":"2017","journal-title":"Census data quality: non-response rates"},{"key":"pmed.1004873.ref012","author":"Australian Bureau of Statistics (ABS)","year":"2012","journal-title":"Core activity need for assistance"},{"key":"pmed.1004873.ref013","unstructured":"Australian Bureau of Statistics (ABS). Understanding disability statistics in the Census and the Survey of Disability, Ageing and Carers: an explanation of disability data available in the Census and other ABS sources. 2022. [cited 15 Oct 2024]. 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