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Incarceration May Be Associated With Higher Cancer Mortality, Yale Study Shows


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New research from Yale Cancer Center reveals a higher risk of cancer mortality in incarcerated adults, as well as among those diagnosed with cancer in the first year after release from prison. The findings were published in the journal PLoS One.1

“Cancer is the leading cause of death among people in prison, accounting for about 30% of all deaths, and yet the complex relationship between incarceration and cancer survival had not been thoroughly evaluated,” said Emily Wang, MD, Professor of Medicine and of Public Health and senior author of the study. She is also Director of the SEICHE Center for Health and Justice at Yale. Oluwadamilola Oladeru, MD, MA, MBA, formerly of Yale and currently with the University of Florida in Gainesville, is the lead author of the study.

Emily Wang, MD

Emily Wang, MD

Oluwadamilola Oladeru, MD, MA, MBA

Oluwadamilola Oladeru, MD, MA, MBA

The study compared data using a statewide link between tumor registry and correctional system data for adults in Connecticut diagnosed with invasive cancer from 2005 through 2016. After the investigators accounted for demographics and cancer characteristics, including stage of diagnosis, the risk for cancer-related death at 5 years was significantly higher among those diagnosed while incarcerated and those recently released compared with the rest of the population.

‘A Call to Action’

“This is a call to action,” said coauthor Cary Gross, MD, Professor of Medicine and of Epidemiology, and founding Director of the Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale School of Medicine. “Cancer prevention and treatment efforts should target people while in prison and identify why incarceration is associated with worse outcomes.”

Cary Gross, MD

Cary Gross, MD

Those diagnosed with invasive cancer while incarcerated and within 1 year of release were also more likely to be younger, male, and non-Hispanic Black or Hispanic. Cancers originating from the gastrointestinal system were the most common cancers in this population, followed by lung and prostate cancers, leukemia, and lymphoma.

“Possible reasons for the high risk of death include having limited access to high-quality cancer care, access to palliative care, and attention to patients’ social determinants of health, including social support and food,” said Dr. Wang.

“Primary care for people recently released from correctional systems should include screening for treatable cancers, evaluation of symptoms, and addressing social determinants to mitigate these disparities in cancer-related deaths,” said Dr. Gross. “Our findings may also be pertinent to other state prison systems, as the national data reveal that cancer is now the leading cause of death among incarcerated individuals.” 

Disclosure: This research was supported by a National Institutes of Health grant. For full disclosures of the study authors, visit journals.plos.org.

Reference

1. Oladeru OT, Aminawung JA, Lin HJ, et al: Incarceration status and cancer mortality: A population-based study. PLoS One. September 16, 2022 (early release online).


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