In the United States, the aging incarcerated population faces a pressing health crisis: cancer. Approximately 15% of incarcerated adults, or about 175,000 individuals, are now aged 55 or older. As this demographic grows, cancer has emerged as a significant health threat, with outcomes for incarcerated individuals notably worse than those for the general population.
A recent study by Yale researchers, published in the journal JAMA Network Open, sheds light on the quality of cancer care received by individuals diagnosed during and shortly after incarceration. The study reveals that these individuals are less likely to receive prompt, guideline-recommended cancer care, potentially contributing to higher mortality rates.
The Study’s Findings
Led by Cary Gross, a professor of medicine and epidemiology at Yale School of Medicine, the study highlights a critical gap in cancer care for incarcerated individuals. “Incarceration is associated with higher cancer-related mortality,” Gross stated. “Because people who are incarcerated have a constitutional right to care, it is particularly important to understand the cancer care that patients are receiving.”
Despite previous research indicating worse cancer outcomes for incarcerated individuals, little was known about the quality of care they receive. The study aimed to fill this gap by evaluating data from the Connecticut Tumor Registry and the Connecticut Department of Correction. Researchers focused on individuals diagnosed with invasive cancer between 2005 and 2016, comparing care quality among those diagnosed during incarceration, within 12 months post-release, and those with no incarceration history.
Key Data Insights
“Patients diagnosed with cancer during incarceration were less likely to initiate treatment within 60 days or receive recommended treatment-related care.”
The study’s analysis of 690 individuals revealed that those diagnosed while incarcerated or shortly after release faced significant delays in receiving treatment. This delay in care initiation, including surgery, chemotherapy, and radiation therapy, underscores the systemic barriers these individuals encounter.
Challenges in Providing Care
Ilana Richman, an assistant professor at Yale and co-author of the study, emphasized the complexities of providing specialized cancer care to incarcerated individuals. “Most specialized cancer care for people who are incarcerated takes place outside of correctional health care settings,” Richman noted. This outsourcing can lead to logistical challenges, such as scheduling appointments and arranging transport to external providers.
Moreover, the financial constraints of government-funded carceral health care can limit contracts with outside facilities, potentially affecting the quality of care. While comprehensive cancer centers offer advanced treatments and better outcomes, the barriers to accessing such care remain significant for incarcerated individuals.
Implications and Future Directions
The findings point to a critical need for systemic changes to improve cancer care for incarcerated populations. “Many of our community members know someone who has a history of criminal justice involvement,” Gross said. “This is a good opportunity to not only advocate for improving the health of these individuals but also to consider the health impact of mass incarceration.”
As researchers continue to develop new cancer screening tests and treatments, ensuring equitable access to these advancements is crucial. The Yale team is conducting further interviews with individuals diagnosed with cancer while incarcerated to gain deeper insights into their experiences.
Gross, who also directs Yale’s Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, along with co-authors including Lisa Puglisi, Rajni Mehta, Emily Wang, Jenerius Aminawung, and M.D. student Jason Weinstein, underscores the importance of addressing these disparities. The study received support from the National Institutes of Health, highlighting the broader significance of this research in shaping public health policies.
As the incarcerated population continues to age, the need for comprehensive, accessible cancer care becomes increasingly urgent. Addressing these gaps not only improves individual health outcomes but also reflects broader societal commitments to justice and equity.
