Cancer in an incarcerated population

BACKGROUND The challenge posed to prison health systems in the U.S. by an immense incarcerated population is significant. However, the patterns of presentation and associated mortality of cancer among the incarcerated population is unknown. METHODS An historical cohort of cancers diagnosed among inm...

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Bibliographic Details
Published in:Cancer 2005-11, Vol.104 (10), p.2197-2204
Main Authors: Mathew, Paul, Elting, Linda, Cooksley, Catherine, Owen, Steven, Lin, James
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
cancer
Continental Population Groups
epidemiology
Female
Humans
incarcerated
Male
Medical sciences
Middle Aged
Neoplasms - epidemiology
Prevalence
prison
Prisoners
Sex Factors
Tumors
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Summary:BACKGROUND The challenge posed to prison health systems in the U.S. by an immense incarcerated population is significant. However, the patterns of presentation and associated mortality of cancer among the incarcerated population is unknown. METHODS An historical cohort of cancers diagnosed among inmates of the Texas Department of Criminal Justice over the course of 20 years who were followed at the University of Texas Medical Branch in Galveston, Texas was identified. There were 1807 inmates who were diagnosed with cancer. Two cohorts were chosen for comparison: a random sample of 179,757 patients from the Surveillance, Epidemiology, and End Results (SEER) registry, and an age‐matched, gender‐matched, race‐matched SEER population comprised of 6124 patients (MSEER). Disease sites and associated mortality of the inmate cancer patients were determined and compared with SEER cohorts. RESULTS A marked rise in cancer diagnoses among inmates paralleled the rise in the inmate population. The leading cancers were lung carcinoma, non‐Hodgkin lymphoma (NHL), and carcinomas of the oral cavity and pharynx. Among women, cervical carcinoma was the most common. Lung carcinoma, NHL, and hepatic carcinoma accounted for more cancer deaths among inmates than in the SEER cohort (P < 0.0001 for all comparisons). Lung carcinoma, hepatic carcinoma, and NHL were significantly more common in the inmate cohort than in the MSEER cohort (P < 0.001 for all comparisons). The median survival was inferior in the inmate cohort (21 mos) compared with the SEER cohort (55 mos) and the MSEER cohort (54 mos) (P < 0.0001 for both comparisons). CONCLUSIONS Cancers with unique epidemiology and high associated mortality have emerged among the incarcerated. This has significant implications for prison health systems. Cancer 2005. © 2005 American Cancer Society. The emergence of cancers with unique epidemiology and high associated mortality among the incarcerated population in the U.S. has significant implications for prison healthcare systems.
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.21468