Automatic life sentence? Inmates more likely to die from cancer, study shows

NEW HAVEN, Conn. — New research from Yale University reports a possible connection between incarceration and cancer. Researchers from the Yale Cancer Center report an observed higher risk of dying from cancer among adults in prison.

Moreover, inmates diagnosed with cancer are more likely to pass away within a year of being released from prison.

“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,” says senior study author Dr. Emily Wang, a professor of medicine and of public health at Yale, in a statement. Dr. Wang is also director of the SEICHE Center for Health and Justice at Yale.

Study authors compared data from tumor registry information and correctional system data spanning adults in Connecticut diagnosed with invasive cancer between 2005-2016. The research team was also sure to account for various additional, potentially influential cancer characteristics, such as stage of diagnosis. Their analysis shows that the risk of a cancer-related death five years post-diagnosis was notably higher among both patients diagnosed while incarcerated and those recently released compared to the remainder of the population.

“This is a call to action,” declares study co-author Dr. Cary Gross, a professor of medicine and of epidemiology, and founding director of the Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) 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.”

Individuals diagnosed with invasive cancer while incarcerated (or within one year of release) were more likely to be younger, male, and non-Hispanic Black or Hispanic. As far as specific cancer varieties, those related to the gastrointestinal system were the most commonly seen among inmates. That’s followed by lung cancer, prostate cancer, 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,” Dr. Wang adds.

Earlier research has pointed to an association between incarceration and cancer survival time, but this new research pinpoints the immediate post-release period as a particularly high-risk period.

“Our findings highlight the value and importance of transition centers for individuals released from carceral settings, the significant barriers associated with cancer care include screening, timely primary care, housing and food security, employment and other structural barriers faced by those re-integrating into society,” comments lead study author Dr. Oluwadamilola Oladeru, an assistant professor of radiation oncology at the University of Florida. Oladeru is also the co-clinical leader of the University of Florida Breast Center.

“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,”Dr. Gross concludes. “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.”

The study is published in PLoS ONE.

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