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The prevalence of disability among people with cancer, cardiovascular disease, chronic respiratory disease and/or diabetes

a systematic review

Lisy, Karolina PhD1,2; Campbell, Jared M. PhD2; Tufanaru, Catalin PhD2; Moola, Sandeep MPhil2; Lockwood, Craig PhD2

International Journal of Evidence-Based Healthcare: September 2018 - Volume 16 - Issue 3 - p 154–166
doi: 10.1097/XEB.0000000000000138

Background: Cardiovascular disease (CVD), cancer, diabetes and chronic respiratory disease are noncommunicable diseases (NCDs) that cause extensive social and economic burden worldwide, particularly in low-income and middle-income countries. There is growing recognition of the importance of the disabilities that individuals experience as a consequence of these NCDs.

Objectives: This systematic review examined the prevalence of disabilities associated with cancer, CVD, chronic respiratory disease and diabetes.

Methods: A comprehensive literature search was conducted in PubMed, CINAHL, Embase, Web of Science, PsycINFO, CIRRIE, WHO database, LILACS and AIM. Studies were included if their samples were representative of people with at least one of these four conditions and if prevalence estimates of disability were provided. As random sampling was not feasible in the majority of cases, studies were included where they offered evidence that their sample was representative of the general population being investigated.

Results: A total of 105 articles were included in the review. Most studies were conducted in high-income countries. The prevalence of difficulties with activities of daily living (i.e. eating, bathing, dressing) was reported to be 10.4–34.5% amongst cancer survivors, 21.1–64.1% in those with CVD, 7.4–49.8% in those with chronic respiratory disease and 12.2–54.5% for those with diabetes. The prevalence of a range of other physical, cognitive and psychological impairments (systemic or structural) was additionally described for each disease.

Conclusion: Substantial proportions of people with cancer, CVD, chronic respiratory disease or diabetes experience some form of disability – although there was great variance in prevalence and definitions. The findings of this review support the evidence base of global impact associated with NCD, indicate frequency measures for specific disabilities and inabilities associated with each NCD and provide direction for future systematic reviews.

What is known about the topic 
  • Communicable diseases (NCDs) of CVD, cancer, diabetes and chronic respiratory disease are associated with significant social and economic challenges worldwide, particularly in low-income and middle-income countries.
  • Chronic NCDs make up the largest cause of disability adjusted life years and have a greater impact than injury, communicable disease, nutrition deficiency and maternal health conditions.
  • Despite the significant needs created globally by these four NCDs, awareness of, and scientific information on, NCD-associated disability and related issues is lacking.
What this article adds 
  • The current study reports international measures of population-based prevalence of disabilities arising from the four main NCDs of cancer, CVD, chronic respiratory disease and diabetes.
  • People with disabilities related to these four NCDs experience restrictions in participation in fundamental life activities such as education, employment and social activities and typically experience a reduced quality of life.
  • Despite evidence of association between NCDs and disability, the cross-sectional design of most studies limits the causal interpretation of existing findings.

1Peter MacCallum Cancer Centre, Melbourne, Victoria

2The Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia

Correspondence: Craig Lockwood, PhD, The Joanna Briggs Institute, The University of Adelaide, 55 King William Street, Level 3 Norwich House, 5006 Adelaide, SA, Australia. E-mail:

International Journal of Evidence-Based Healthcare © 2018 The Joanna Briggs Institute
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