Study shows incarceration associated with higher cancer mortality

21 Sep 2022
Study shows incarceration associated with higher cancer mortality

New research from Yale Cancer Center reveals a higher risk of cancer mortality in incarcerated adults, as well as those diagnosed with cancer in the first-year post-release from prison.

The study describing the findings was published today in PLOS ONE.

“Cancer is the leading cause of death among people in prison, accounting for about thirty percent 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 (General Medicine) and of Public Health (Social and Behavioral Sciences) and senior author of the study. Dr Wang is also Director of the SEICHE Center for Health and Justice at Yale.

The study compared data using a statewide linkage of tumour registry and correctional system data for adults in Connecticut diagnosed with invasive cancer from 2005 through 2016.

After accounting for demographics and cancer characteristics, including stage of diagnosis, the risk for cancer-related death at five years was significantly higher among those diagnosed while incarcerated and those recently released compared to the remainder of the population.

Cary Gross, MD, Professor of Medicine (General Medicine) and of Epidemiology (Chronic Diseases), and co-author on the study commented, “We determined that cancer prevention and treatment efforts should target people while in prison, and identify why incarceration is associated with worse outcomes.”  Dr. Gross is also Founding Director of the Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center at Yale School of Medicine.

Those diagnosed with invasive cancer while incarcerated and within one-year post-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, as well as lung and prostate cancer, and leukaemia and lymphoma.

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

While prior studies have identified the association between incarceration and cancer survival time, this study illuminates the immediate post release period as a particularly high-risk period.

“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.” 

Source: Yale Cancer Center