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Lüchtenborg M, Huynh J, Armes J, Plugge E, Hunter RM, Visser R, Taylor RM, Davies EA. Cancer incidence, treatment, and survival in the prison population compared with the general population in England: a population-based, matched cohort study. Lancet Oncol 2024; 25:553-562. [PMID: 38697154 DOI: 10.1016/s1470-2045(24)00035-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND The growing and ageing prison population in England makes accurate cancer data of increasing importance for prison health policies. This study aimed to compare cancer incidence, treatment, and survival between patients diagnosed in prison and the general population. METHODS In this population-based, matched cohort study, we used cancer registration data from the National Cancer Registration and Analysis Service in England to identify primary invasive cancers and cervical cancers in situ diagnosed in adults (aged ≥18 years) in the prison and general populations between Jan 1, 1998, and Dec 31, 2017. Ministry of Justice and Office for National Statistics population data for England were used to calculate age-standardised incidence rates (ASIR) per year and age-standardised incidence rate ratios (ASIRR) for the 20-year period. Patients diagnosed with primary invasive cancers (ie, excluding cervical cancers in situ) in prison between Jan 1, 2012, and Dec 31, 2017 were matched to individuals from the general population and linked to hospital and treatment datasets. Matching was done in a 1:5 ratio according to 5-year age group, gender, diagnosis year, cancer site, and disease stage. Our primary objectives were to compare the incidence of cancer (1998-2017); the receipt of treatment with curative intent (2012-17 matched cohort), using logistic regression adjusted for matching variables (excluding cancer site) and route to diagnosis; and overall survival following cancer diagnosis (2012-17 matched cohort), using a Cox proportional hazards model adjusted for matching variables (excluding cancer site) and route to diagnosis, with stratification for the receipt of any treatment with curative intent. FINDINGS We identified 2015 incident cancers among 1964 adults (1556 [77·2%] men and 459 [22·8%] women) in English prisons in the 20-year period up to Dec 31, 2017. The ASIR for cancer for men in prison was initially lower than for men in the general population (in 1998, ASIR 119·33 per 100 000 person-years [95% CI 48·59-219·16] vs 746·97 per 100 000 person-years [742·31-751·66]), but increased to a similar level towards the end of the study period (in 2017, 856·85 per 100 000 person-years [675·12-1060·44] vs 788·59 per 100 000 person-years [784·62-792·57]). For women, the invasive cancer incidence rate was low and so ASIR was not reported for this group. Over the 20-year period, the incidence of invasive cancer for men in prison increased (incidence rate ratio per year, 1·05 [95% CI 1·04-1·06], during 1999-2017 compared with 1998). ASIRRs showed that over the 20-year period, overall cancer incidence was lower in men in prison than in men in the general population (ASIRR 0·76 [95% CI 0·73-0·80]). The difference was not statistically significant for women (ASIRR 0·83 [0·68-1·00]). Between Jan 1, 2012, and Dec 31, 2017, patients diagnosed in prison were less likely to undergo curative treatment than matched patients in the general population (274 [32·3%] of 847 patients vs 1728 [41·5%] of 4165; adjusted odds ratio (OR) 0·72 [95% CI 0·60-0·85]). Being diagnosed in prison was associated with a significantly increased risk of death on adjustment for matching variables (347 deaths during 2021·9 person-years in the prison cohort vs 1626 deaths during 10 944·2 person-years in the general population; adjusted HR 1·16 [95% CI 1·03-1·30]); this association was partly explained by stratification by curative treatment and further adjustment for diagnosis route (adjusted HR 1·05 [0·93-1·18]). INTERPRETATION Cancer incidence increased in people in prisons in England between 1998 and 2017, with patients in prison less likely to receive curative treatments and having lower overall survival than the general population. The association with survival was partly explained by accounting for differences in receipt of curative treatment and adjustment for diagnosis route. Improved routine cancer surveillance is needed to inform prison cancer policies and decrease inequalities for this under-researched population. FUNDING UK National Institute for Health and Care Research, King's College London, and Strategic Priorities Fund 2019/20 of Research England via the University of Surrey.
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Affiliation(s)
- Margreet Lüchtenborg
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, UK; National Disease Registration Service, Data and Analytics, Transformation Directorate, NHS England, UK
| | - Jennie Huynh
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, UK; National Disease Registration Service, Data and Analytics, Transformation Directorate, NHS England, UK
| | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Emma Plugge
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rachael M Hunter
- Applied Health Research, Institute of Epidemiology and Health, University College London, London, UK
| | - Renske Visser
- Faculty of Education and Psychology, University of Oulu, Oulu, Finland
| | - Rachel M Taylor
- Centre for Nurse, Midwife and Allied Health Professional Research, University College London Hospitals NHS Foundation Trust, London, UK
| | - Elizabeth A Davies
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, UK.
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Puglisi L, Halberstam AA, Aminawung J, Gallagher C, Gonsalves L, Schulman-Green D, Lin HJ, Metha R, Mun S, Oladeru OT, Gross C, Wang EA. Incarceration and Cancer-Related Outcomes (ICRO) study protocol: using a mixed-methods approach to investigate the role of incarceration on cancer incidence, mortality and quality of care. BMJ Open 2021; 11:e048863. [PMID: 34035109 PMCID: PMC8154989 DOI: 10.1136/bmjopen-2021-048863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Incarceration is associated with decreased cancer screening rates and a higher risk for hospitalisation and death from cancer after release from prison. However, there is a paucity of data on the relationship between incarceration and cancer outcomes and quality of care. In the Incarceration and Cancer-Related Outcomes Study, we aim to develop a nuanced understanding of how incarceration affects cancer incidence, mortality and treatment, and moderates the relationship between socioeconomic status, structural racism and cancer disparities. METHODS AND ANALYSIS We will use a sequential explanatory mixed-methods study design. We will create the first comprehensive linkage of data from the Connecticut Department of Correction and the statewide Connecticut Tumour Registry. Using the linked dataset, we will examine differences in cancer incidence and stage at diagnosis between individuals currently incarcerated, formerly incarcerated and never incarcerated in Connecticut from 2005 to 2016. Among individuals with invasive cancer, we will assess relationships among incarceration, quality of cancer care and mortality, and will assess the degree to which incarceration status moderates relationships among race, socioeconomic status, quality of cancer care and cancer mortality. We will use multivariable logistic regression and Cox survival models with interaction terms as appropriate. These results will inform our conduct of in-depth interviews with individuals diagnosed with cancer during or shortly after incarceration regarding their experiences with cancer care in the correctional system and the immediate postrelease period. The results of this qualitative work will help contextualise the results of the data linkage. ETHICS AND DISSEMINATION The Yale University Institutional Review Board (#2000022899) and the Connecticut Department of Public Health Human Investigations Committee approved this study. We will disseminate study findings through peer-reviewed publications and academic and community presentations. Access to the deidentified quantitative and qualitative datasets will be made available on review of the request.
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Affiliation(s)
- Lisa Puglisi
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Jenerius Aminawung
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Colleen Gallagher
- Connecticut Department of Correction, Wethersfield, Connecticut, USA
| | - Lou Gonsalves
- Connecticut Tumor Registry, Connecticut Department of Public Health, Hartford, Connecticut, USA
| | - Dena Schulman-Green
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Hsiu-Ju Lin
- School of Social Work, University of Connecticut System, Storrs, Connecticut, USA
- Research Division, Connecticut Department of Mental Health and Addiction Services, Hartford, Connecticut, USA
| | - Rajni Metha
- Yale Rapid Case Ascertainment, Yale Cancer Center, New Haven, Connecticut, USA
| | - Sophia Mun
- Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, New Haven, Connecticut, USA
| | - Oluwadamilola T Oladeru
- Harvard Radiology Oncology Program, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Cary Gross
- Department of Internal Medicine, Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, New Haven, Connecticut, USA
| | - Emily A Wang
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Escobar N, Plugge E. Prevalence of human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer in imprisoned women worldwide: a systematic review and meta-analysis. J Epidemiol Community Health 2019; 74:95-102. [DOI: 10.1136/jech-2019-212557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 11/04/2022]
Abstract
Background and objectivesImprisoned women have higher rates of abnormalities at cervical screening and some studies suggest that cervical cancer is the most common cancer in this population. The aim of this work was to summarise the current evidence on the prevalence of human papilloma virus (HPV) infection, cervical cancer and precancerous lesions in women in prison worldwide and to compare these rates with the general population.MethodsWe systematically searched and reviewed published and unpublished data reporting the prevalence of any HPV infection, cervical intraepithelial neoplasia (CIN) and cervical cancer in imprisoned women. We created forest plots with prevalence estimates from studies with comparable outcomes and of prevalence ratios using data from national screening programmes as a comparison group.FindingsA total of 53 533 imprisoned women from 10 countries and 35 studies were included in the review. The prevalence of HPV among prisoners ranged from 10.5% to 55.4% with significant heterogeneity. The prevalence of CIN diagnosed by cytology in prisoners ranged from 0% to 22%. Ratios comparing the prevalence of CIN in imprisoned women to that in the community ranged from 1.13 to 5.46. Cancer prevalence estimates were at least 100 times higher than in populations participating in national screening programmes.ConclusionImprisoned women are at higher risk of cervical cancer than the general population. There is a high prevalence of HPV infection and precancerous lesions in this population. Targeted programmes for control of risk factors and the development of more effective cervical screening programmes are recommended.PROSPERO registration numberCRD42014009690.
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Brousseau EC, Ahn S, Matteson KA. Cervical Cancer Screening Access, Outcomes, and Prevalence of Dysplasia in Correctional Facilities: A Systematic Review. J Womens Health (Larchmt) 2019; 28:1661-1669. [PMID: 30939063 DOI: 10.1089/jwh.2018.7440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background: Incarcerated women often access health care primarily through contact with correctional systems. Cervical cancer screening within the correctional system can address the preventable outcome of cervical dysplasia and cancer in this high-risk population. Materials and Methods: A search of PubMed, EMBASE, CINAHL, and ClinicalTrials.gov was conducted for articles published between January, 1966 and December, 2018. All studies on a population of jailed or incarcerated females and at least one of the following outcomes: cervical cancer or dysplasia, pap smear screening, knowledge about screening, treatment of cervical dysplasia, and compliance with follow-up were analyzed. Results: Forty-two studies met inclusion criteria. All 21 studies with prevalence outcomes described a higher prevalence of cervical dysplasia and cancer in the women involved with corrections, compared to a variety of different sources that served as community control groups. The data on screening outcomes were inconsistent. Follow-up compliance for abnormal results was poor, with a study finding that only 21% of women were rescreened within 6 months of the recommended time period. Knowledge about cervical cancer and screening was evaluated in eight studies and was poor across all studies. Conclusion: Women involved in correctional systems have a higher prevalence of cervical dysplasia and cancer than women in the general population. Acceptance of screening varies, and no published interventions have been shown to improve screening within the prison system. Treatment and compliance with follow-up recommendations are extremely poor and should be a focus of future research.
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Affiliation(s)
- Erin Christine Brousseau
- Department of Obstetrics and Gynecology, Women and Infants Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Susie Ahn
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
| | - Kristen A Matteson
- Department of Obstetrics and Gynecology, Women and Infants Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Renault L, Perrot E, Pradat E, Bartoli C, Greillier L, Remacle-Bonnet A, Telmon N, Mazières J, Molinier L, Couraud S. Concerns About Lung Cancer Among Prisoners. Lung 2018; 196:115-124. [PMID: 29299681 DOI: 10.1007/s00408-017-0066-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/01/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Few studies have looked at lung cancer in prisoners, despite this population is possibly at increased risk of malignancy. In a previous study, we found an early onset of lung cancer in prisoners. Thus, the present CARCAN study was aimed at assessing the epidemiological characteristics, management, prognosis, and incidence of lung cancer in prisoners compared to a sample of non-prisoner patients. METHOD We performed a multi-center observational case-control study. Cases were prisoners diagnosed with lung cancer from 2005 to 2013. Controls were non-prisoner lung cancer patients selected from hospital databases and randomly matched to cases (targeted case-control ratio: 1:3). Incidence rates in both groups were calculated using national statistics. RESULTS Seventy-two cases and 170 controls met inclusion criteria. Cases were mainly men (99%). Mean age at diagnosis was 52.9 (± 11.0) in cases and 64.3 (± 10.1) in controls (p < 0.0001). More case patients were current smokers compared to control patients (83% vs 53%; p < 0.0001). We found no significant differences between the two groups as concerns histologic types, TNM stages at diagnosis, initially-employed treatments, times to management or survival. Incidence rates (2008-2012) in male prisoners were higher than those in the general population in all concerned age groups. CONCLUSION There is a shift of lung cancer toward young people in prisons. However, the presentation, management, and prognosis of lung cancer are similar between prisoners and non-prisoners. These finding could justify a specific screening policy for the incarcerated populations.
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Affiliation(s)
- Luc Renault
- Faculté de Médecine Lyon Est, Université Lyon 1, 69008, Lyon, France
| | - Emmanuel Perrot
- Unité Hospitalière Sécurisée Interrégionale, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, 69310, Pierre Bénite, France
| | - Eric Pradat
- Département d'Information Médicale, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, 69310, Pierre Bénite, France
| | - Christophe Bartoli
- UMR 7268 ADES, CNRS, EFS, Aix-Marseille Université, 13284, Marseille, France.,Unité Hospitalière Sécurisée Interrégionale, Service de médecine en milieu pénitentiaire, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France
| | - Laurent Greillier
- Service Oncologie multidisciplinaire et innovations thérapeutiques, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France.,Aix Marseille Université, 13284, Marseille, France
| | - Anne Remacle-Bonnet
- Service d'Information Médicale, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France
| | - Norbert Telmon
- Service de Médecine légale et pénitentiaire, Hôpital Rangueil, Centre Hospitalier Universitaire de Toulouse, 31059, Toulouse, France.,UMR 5288, CNRS, Faculté de Médecine Purpan, Université Toulouse III, 31000, Toulouse, France
| | - Julien Mazières
- Service de pneumologie, Hôpital Larrey, Centre Hospitalier Universitaire de Toulouse, 31059, Toulouse, France.,Université Toulouse III - Paul Sabatier, 31062, Toulouse, France
| | - Laurent Molinier
- Département d'Information Médicale, Hôtel-Dieu Saint-Jacques, Centre Hospitalier Universitaire de Toulouse, 31059, Toulouse, France.,UMR 1027 INSERM - Université Toulouse III - Paul Sabatier, 31062, Toulouse, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, 165 chemin du grand Revoyet, 69310, Pierre Bénite, France. .,EMR3738 Ciblage thérapeutique en oncologie, Faculté de Médecine Lyon Sud-Charles Mérieux, Université Lyon 1, 69600, Oullins, France.
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Cancer prevalence, incidence and mortality in people who experience incarceration in Ontario, Canada: A population-based retrospective cohort study. PLoS One 2017; 12:e0171131. [PMID: 28225780 PMCID: PMC5321272 DOI: 10.1371/journal.pone.0171131] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/16/2017] [Indexed: 01/19/2023] Open
Abstract
Introduction Evidence suggests that many risk factors for cancer are overrepresented in people who experience incarceration, and data on cancer epidemiology are limited for this population. We aimed to describe cancer prevalence, incidence and mortality in adults admitted to provincial custody in Ontario, Canada in 2000. Methods We linked data on 48,166 adults admitted to provincial custody in Ontario in 2000 with Ontario Cancer Registry data to 2012. We calculated cancer prevalence in the 10 years prior to admission to custody in 2000, incidence between 2000 and 2012 and mortality between 2000 and 2011. Standardized for age, we calculated incidence and mortality ratios by sex compared to the general population of Ontario. Results The 10-year cancer prevalence was 0.4% in men and 0.6% in women at admission to provincial custody in 2000. Between 2000 and 2012, 2.6% of men and 2.8% of women were diagnosed with new cancer. The standardized incidence ratio for cancer was 1.0 (95% CI 0.9–1.0) for men and 0.9 (95% CI 0.7–1.0) for women compared to the general population, and was significantly increased for cervical, head and neck, liver and lung cancers. The standardized mortality ratio was 1.6 (95% CI 1.4–1.7) in men and 1.4 (95% CI 1.0–1.9) in women, and was significantly increased for head and neck, liver, and lung cancers. Conclusions There is an excess burden of cancer in people who experience incarceration. Cancer prevention should include people who experience incarceration, and the period of incarceration may offer an opportunity for intervention.
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Turaka A. Challenges in Treating Incarcerated Patients With Cancer. Int J Radiat Oncol Biol Phys 2016; 95:1083. [DOI: 10.1016/j.ijrobp.2016.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 01/25/2016] [Indexed: 10/21/2022]
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Olds J, Reilly R, Yerrell P, Stajic J, Micklem J, Morey K, Brown A. Exploring barriers to and enablers of adequate healthcare for Indigenous Australian prisoners with cancer: a scoping review drawing on evidence from Australia, Canada and the United States. HEALTH & JUSTICE 2016; 4:5. [PMID: 27226946 PMCID: PMC4854927 DOI: 10.1186/s40352-016-0036-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group. METHODS This scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation. RESULTS Eight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons' concern with security versus the need for timely access to medical care. CONCLUSION Findings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians' over-burden of cancer mortality and over-representation in the prison system, further research is needed to identify whether there are a unique set of barriers for this group.
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Affiliation(s)
- Jessica Olds
- Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia
| | - Rachel Reilly
- Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia
| | - Paul Yerrell
- Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia
| | - Janet Stajic
- Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia
| | - Jasmine Micklem
- Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia
| | - Kim Morey
- Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia
| | - Alex Brown
- Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia
- Centre for Population Health Research, University of South Australia, Adelaide, Australia
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Maschi T, Marmo S, Han J. Palliative and end-of-life care in prisons: a content analysis of the literature. Int J Prison Health 2014; 10:172-97. [DOI: 10.1108/ijph-05-2013-0024] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The growing numbers of terminally ill and dying in prison has high economic and moral costs as global correctional systems and the society at large. However, to date little is known about the extent to which palliative and end-of-life care is infused within global prison health care systems. The purpose of this paper is to fill a gap in the literature by reviewing and critically appraising the methods and major findings of the international peer-reviewed literature on palliative and end-of-life care in prison, identify the common elements of promising palliative and end-of-life services in prison, and what factors facilitate or create barrier to implementation.
Design/methodology/approach
– A content analysis was conducted of the existing peer-reviewed literature on palliative and end-of-life care in prison. English-language articles were located through a comprehensive search of peer-reviewed journals, such as Academic Search Premier Literature databases using differing combinations of key word search terms, “prison,” “palliative care,” and “end-of-life care.” A total of 49 studies published between 1991 and 2013 met criteria for sample inclusion. Deductive and inductive analysis techniques were used to generate frequency counts and common themes related to the methods and major findings.
Findings
– The majority (n=39) of studies were published between 2001-2013 in the USA (n=40) and the UK (n=7). Most were about US prison hospice programs (n=16) or barriers to providing palliative and end of life care in prisons (n=10). The results of the inductive analysis identified common elements of promising practices, which included the use of peer volunteers, multi-disciplinary teams, staff training, and partnerships with community hospices. Obstacles identified for infusing palliative and end-of-life care in prison included ethical dilemmas based on custody vs care, mistrust between staff and prisoners, safety concerns, concern over prisoners’ potential misuse of pain medication, and institutional, staff, and public apathy toward terminally ill prisoners and their human rights to health in the form of compassionate and palliative care, including the use of compassionate release laws.
Research limitations/implications
– Implications for future research that foster human rights and public awareness of the economic and moral costs of housing the sick and dying in prisons. More research is needed to document human rights violations as well as best practices and evidence-based practices in palliative and end-of-life care in prisons. Future studies should incorporate data from the terminally ill in prison, peer supports, and family members. Future studies also should employ more rigorous research designs to evaluate human rights violations, staff and public attitudes, laws and policies, and best practices. Quantitative studies that use experimental designs, longitudinal data, and multiple informants are needed. Qualitative data would allow for thick descriptions of key stakeholders experiences, especially of the facilitators and barriers for implementing policy reform efforts and palliative care in prisons.
Practical implications
– This review provides a foundation on which to build on about what is known thus far about the human right to health, especially parole policy reform and infusing palliative and end-of-life care for the terminally ill and dying in prisons. This information can be used to develop or improve a new generation research, practice, policy, and advocacy efforts for that target terminally ill and dying in prison and their families and communities.
Social implications
– There are significant social implications to this review. From a human rights perspective, the right to freedom from torture and cruel and unusual punishment is a fundamental human right along with prisoners’ rights for an appropriate level of health care. These rights should be guaranteed regardless of the nature of their crime or whether they are in a prison placement. The information provided in this review can be used to educate and possible transform individual's and society's views toward the terminally ill and dying who are involved in the criminal justice system.
Originality/value
– This paper extends the extant literature by using both quantitative and qualitative analysis methods to organize, summarize, and critically analyze the international literature on palliative care and end of life care in prison. This review is designed to increase awareness among the international community of the pain and suffering of the terminally ill in prison and the facilitators and barriers to providing them compassionate care while in custody.
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Carbonnaux M, Fossard G, Amzallag E, Piegay C, Perot E, Chossegros P, Souquet PJ, Couraud S. Earlier onset and poor prognosis of lung cancer in imprisoned patients. Oncology 2013; 85:370-7. [PMID: 24335502 DOI: 10.1159/000356877] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 10/23/2013] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Prison inmates are known to be more exposed to various lung cancer risk factors, and some studies have shown that lung cancer is the most common cancer in prisoners. However, no study has particularly focused on lung cancer features in this population. METHOD Charts of patients with lung cancer hospitalized in one of the French secured hospital units between 1997 and 2012 were reviewed. Data from this cohort were then compared to those of two large observational studies conducted in 2000 and 2010 (KBP studies). RESULTS Thirty-two cases were included. All were men. The mean age was 52.2 ± 11.5 years, which was significantly lower than in the KBP-2000 (64.4 years) and KBP-2010 (65.5 years; both p < 0.0001) studies. The percentage of current smokers was much higher in prisoners (87.1 vs. 52.2 and 49.2%, respectively; both p < 0.001). Ninety percent of prisoners presented with at least one comorbidity. Lung cancer clinical presentation did not differ between prisoners and the reference populations. The median overall survival was 5.8 months (range 0-15.1) for all stages and 4.7 months (range 2.8-6.6) for stage IIIB/IV. CONCLUSION Although our study suffers from limitations, prisoners seem to develop lung cancer at a younger age and their prognosis is poor.
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Affiliation(s)
- M Carbonnaux
- Department of Pulmonary Medicine, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre Bénite, France
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Stone K, Papadopoulos I, Kelly D. Establishing hospice care for prison populations: An integrative review assessing the UK and USA perspective. Palliat Med 2012; 26:969-78. [PMID: 21993807 DOI: 10.1177/0269216311424219] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND models of care based on the hospice model have delivered effective support to dying people since their inception. Over the last 20 years this form of care has also been introduced into the prison system (mainly in the United States) to afford terminally ill inmates the right to die with dignity. AIM the aim of this review is to examine the evidence from the United States and the United Kingdom on the promotion of palliative care in the prison sector, summarizing examples of good practice and identifying barriers for the provision of end-of-life care within the prison environment both in the USA and UK. DESIGN an integrative review design was adopted using the Green et al. model incorporating theoretical and scientific lines of enquiry. DATA SOURCES literature was sourced from six electronic databases between the years 2000 and 2011; the search rendered both qualitative and quantitative papers, discussion papers, 'grey literature' and other review articles. RESULTS the results highlight a number of issues surrounding the implementation of palliative care services within the prison setting and emphasize the disparity between the USA model of care (which emphasizes the in-prison hospice) and the UK model of care (which emphasizes palliative care in-reach) for dying prisoners. CONCLUSION the provision of palliative care for the increasing prison population remains under-researched globally, with a notable lack of evidence from the United Kingdom.
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Affiliation(s)
- Katie Stone
- School of Health and Social Sciences, Middlesex University, London, UK
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Howe JB, Scott G. Educating prison staff in the principles of end-of-life care. Int J Palliat Nurs 2012; 18:391-5. [DOI: 10.12968/ijpn.2012.18.8.391] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jill Banks Howe
- End of Life Care, School of Health and Social Care, Teesside University, Borough Road, Middlesbrough, TS1 3BA
| | - Gill Scott
- Prison Project Lead, County Durham and Darlington Foundation Trust, Easington Macmillan Service, Co Durham
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