Shocking inequalities experienced by men with learning disabilities when diagnosed with prostate cancer have been highlighted in a study funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC).

Published in the journal European Urology Oncology today (20 Feb 2026), 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 was conducted by University of Manchester and Christie NHS Foundation Trust researchers. 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.”

NOTES FOR EDITORS

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.

FDOI : https://doi.org/10.1016/j.euo.2026.01.004

For media enquires contact:

Mike Addelman
Media Relations Officer
Animal Research Communications Lead
Faculty of Biology, Medicine and Health
University of Manchester
07717 881567
michael.addelman@manchester.ac.uk

About The University of Manchester


The University of Manchester is recognised globally for its pioneering research, outstanding teaching and learning, and commitment to social responsibility. Part of the Russell Group, we’re ranked 35th in the QS World University Rankings, 2025 (6th in the UK) and 46th in the Academic Ranking of World Universities, 2025.

The power of our social and environmental impact has been recognised on a global scale as the only university in the top ten in both the QS World University Sustainability Rankings and Times Higher Education Impact Rankings, for our contribution towards the United Nations’ Sustainable Development Goals (SDGs).

Our university is a powerhouse of research and discovery; 26 Nobel laureates are among our former staff and students, and we were ranked fifth for research power – the quality and scale of research and impact – in the Research Excellence Framework (REF), 2021.

Ranked 20th most international university in the world according to Times Higher Education (2025), our community includes more than 44,000 students, 12,800 staff and 550,000 alumni from 190 countries, working together to tackle the world’s biggest challenges.

We’re one of the most popular institutions in the UK for undergraduate applications, according to UCAS, and were the most targeted university by the UK’s leading employers in 2024 (The Graduate Market). Learn more at www.manchester.ac.uk.

About the NIHR

This study was funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC).

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research.

We do this by:

• funding high quality, timely research that benefits the NHS, public health and social care
• investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
• partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
• attracting, training and supporting the best researchers to tackle complex health and social care challenges
• collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
• funding applied global health research and training to meet the needs of the poorest people in low and middle income countries

NIHR is funded by the Department of Health and Social Care.

Our work in low and middle income countries is principally funded through UK international development funding from the UK .

About Mencap

Mencap exists to ensure the UK is the best place in the world for people with a learning disability to live happy and healthy lives. We support people directly and campaign with people with a learning disability, their families and carers. We work to change laws, increase representation and campaign for better health, social care and employment opportunities for the 1.5 million people with a learning disability in the UK. mencap.org.uk

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