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Maya Razmi
Cancer is one of the leading causes of death worldwide – in 2022, there were about 20 million new cases of cancer and 9.7 million cancer-related deaths. Though some individuals have access to treatment, many may not be so fortunate. Vulnerable populations are particularly susceptible to cancer, as they would any other health condition. A particularly vulnerable, understudied population includes incarcerated people. Though the higher rates of mental health conditions, substance use disorder, and infectious diseases in prison populations have been studied, little research has focused on the rates of non-communicable diseases in these populations despite higher rates of risk factors for cancer such as smoking, and drug and alcohol use.
However, a recent study has started to fill this research gap. This study investigated populations in the United Kingdom. The UK has one of the highest prison populations in Western Europe. In this study, a population-based, matched cohort method (847 patients in prison and 4165 patients not in prison) using national cancer registration data in England was used to analyze cancer incidence and treatment in prison populations.
Researchers found that there were higher cancer rates among prison populations compared to the general population. In particular, they found that certain types of cancer, such as liver and lung cancer, have a higher prevalence in prisons. It was difficult to determine why this was the case – though the typically lower socioeconomic background of people in prison could partially explain their lower overall survival, the individual’s postcode at diagnosis for incarcerated people was that of the prison, and their previous postcode of residence was not available.
Understanding how vulnerable populations are disproportionately impacted by diseases such as cancer allows physicians working in carceral settings to more effectively allocate care toward and advocate for incarcerated persons.
Also important to understanding how to improve cancer treatment for those in prison is studying the outcomes of cancer treatment among prison populations. Overall, according to the study, the survival of those diagnosed with cancer in prison was much lower than those in the general population: with a 1-year survival of 71.1% compared to 74.3% and a 5-year survival rate of 54.3% compared to 56.6%. This statistically significant difference may indicate a disparity in the treatment that different populations can access. Among the prison population diagnosed with cancer, the same study found that only 32.3% received any treatment with curative intent, compared to 41.5% in the matched general population. Notably, the study also found that cancer diagnoses in patients in prison were less likely to result from outpatient referral routes compared to emergency admissions. Researchers hypothesize that these barriers to curative treatment could be due to security measures, unavailability of staff, inadequate communication between health professionals or unavailability of information. This indicates a significant disparity in access to treatment for incarcerated individuals and underscores the importance of targeted prevention and screening efforts within prison populations, given their unique healthcare needs.
The findings of this study underscore the critical need for targeted interventions to address cancer-related health disparities among incarcerated individuals. By understanding the unique challenges faced by this population, we can develop tailored strategies to improve cancer prevention, diagnosis, treatment, and survivorship within prison settings. Ultimately, addressing health inequities in cancer care is essential for ensuring equitable access to healthcare for all individuals, regardless of their incarceration status. As we continue to advance our understanding of cancer and its social determinants, let us not forget those who are often marginalized in our efforts to combat this disease.
Header Image Source: https://americanoversight.org/investigation/the-pandemic-in-prisons/
Edited by Kate Secombe
References
Cancer Statistics. (n.d.). National Cancer Institute. Retrieved August 6, 2024, from https://www.cancer.gov/about-cancer/understanding/statistics#:~:text=Cancer%20is%20among%20the%20leading,related%20deaths%20to%2015.3%20million
Fleck, A. (2023, October 23). The Western European Nations Imprisoning the Most People. Statista. https://www.statista.com/chart/31061/highest-prisoner-rates-in-western-europe/#:~:text=England%20and%20Wales%20have%20the,the%20two%20countries%20in%202023.
Lüchtenborg, M., Huynh, J., Armes, J., Plugge, E., Hunter, R., Visser, R., Taylor, R., & Davies, E. (2024). Cancer incidence, treatment, and survival in the prison population compared with the general population in England: a population-based, matched cohort study. Vol 25. https://doi.org/https://doi.org/10.1016/ S2589-5370(24)00154-8 https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00035-4/fulltext
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