Journal article
Cancer Care in the Incarcerated Population Barriers to Quality Care and Opportunities for Improvement
JAMA surgery, Vol.156(10), pp.964-973
10/01/2021
DOI: 10.1001/jamasurg.2021.3754
PMID: 34406357
Abstract
IMPORTANCE Cancer is the leading cause of mortality in incarcerated individuals older than 45 years and the fourth leading cause of mortality overall. Health care professionals face increasing challenges to provide high-quality care under the confines of prison regulations and procedures.
OBSERVATIONS Adjusted for age, race, sex, and year of diagnosis, the standardized incidence ratio for all cancers is more than 2-fold higher in incarcerated vs general populations. Among deaths occurring in state and federal prison systems, cancer is the overall leading cause of mortality with lung cancer being the leading cause of cancer-related mortality followed by liver, colon, and pancreatic cancers, respectively. Access to high-quality oncological services remains variable; however, cost of care represents about a fifth of overall annual prison expenditures. Given the enormous patient burden, coupled with the rushed discretionary screenings performed by jail and prison nursing staff, early cancer symptoms are often missed altogether or misdiagnosed as a chronic illness or as acute infections. As such, many incarcerated individuals present with more advanced cancer stage. Incarcerated individuals have limited, if any, access to the internet, social media, and other sources of information, which severely limits their ability to research treatment options. Within the prison setting, access to professionals with special skills in assisting with social and spiritual concerns is also generally limited, and less than 4% of prisons have hospice programs. There are no uniform quality-of-care monitoring standards for correctional systems and facilities, nor are there mechanisms for reporting comparable performance data to enforce quality control within correctional health care systems.
CONCLUSIONS AND RELEVANCE There is a growing trend in cancer incidence among incarcerated patients, which is multifactorial including barriers in access to care, increased burden of chronic medical conditions, and decreased screening tests. Efforts are needed to ensure quality health care outcomes for incarcerated patients with cancer.
Details
- Title: Subtitle
- Cancer Care in the Incarcerated Population Barriers to Quality Care and Opportunities for Improvement
- Creators
- Hassan Aziz - Tufts Medical CenterRuth L. Ackah - The Ohio State University Wexner Medical CenterAmy Whitson - The Ohio State University Wexner Medical CenterBridget Oppong - The Ohio State University Wexner Medical CenterSamilia Obeng-Gyasi - The Ohio State UniversityCarrie Sims - The Ohio State University Wexner Medical CenterTimothy M. Pawlik - The Ohio State University Wexner Medical Center
- Resource Type
- Journal article
- Publication Details
- JAMA surgery, Vol.156(10), pp.964-973
- Publisher
- Amer Medical Assoc
- DOI
- 10.1001/jamasurg.2021.3754
- PMID
- 34406357
- ISSN
- 2168-6254
- eISSN
- 2168-6262
- Number of pages
- 10
- Language
- English
- Date published
- 10/01/2021
- Academic Unit
- Surgery
- Record Identifier
- 9984701544902771
Metrics
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