Incarceration status and cancer mortality: A population-based study.
Incarceration status and cancer mortality: A population-based study.
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DOI：
10.1371/journal.pone.0274703
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
监禁与癌症存活率之间的复杂关系尚未得到彻底评估。我们评估了在监禁期间或释放后立即诊断出癌症与从未被监禁的人相比是否与更高的死亡率相关。我们进行了一项基于人群的研究，使用了2005年至2016年诊断为浸润性癌症的康涅狄格州成年居民的全州肿瘤登记和矫正系统运动数据的联系。自变量是癌症诊断的地点：监禁期间，释放后12个月内，从未监禁。因变量为5年癌症相关和总生存率。在研究期间被诊断患有浸润性癌症的216，540名成年人中，239人（0.11%）在监禁期间被诊断，479人（0.22%）在释放后12个月内被诊断，其余人从未被监禁。在考虑人口统计学和癌症特征（包括诊断阶段）后，与从未被监禁的组相比，在监禁期间诊断的患者（AHR = 1.39，95%CI = 1.12-1.73）和最近释放的患者（AHR = 1.82，95%CI = 1.57-2.10）中，5年时癌症相关死亡的风险显著更高。在被监禁期间诊断为癌症的患者（AHR = 1.92，95% CI = 1.63-2.26）和最近释放的患者（AHR = 2.18，95% CI = 1.94-2.45）的全因死亡率风险也较高。在监禁期间和释放后第一年被诊断出患有癌症的人中，癌症死亡的风险较高，诊断阶段不能完全解释这一点。癌症预防和治疗工作应该针对那些经历过监禁的人，并确定为什么监禁与更糟糕的结果有关。
The complex relationship between incarceration and cancer survival has not been thoroughly evaluated. We assessed whether cancer diagnosis during incarceration or the immediate post-release period is associated with higher rates of mortality compared with those never incarcerated. We conducted a population-based study using a statewide linkage of tumor registry and correctional system movement data for Connecticut adult residents diagnosed with invasive cancer from 2005 through 2016. The independent variable was place of cancer diagnosis: during incarceration, within 12 months post-release, and never incarcerated. The dependent variables were five-year cancer-related and overall survival rates. Of the 216,540 adults diagnosed with invasive cancer during the study period, 239 (0.11%) people were diagnosed during incarceration, 479 (0.22%) within 12 months following release, and the remaining were never incarcerated. After accounting for demographics and cancer characteristics, including stage of diagnosis, the risk for cancer-related death at five years was significantly higher among those diagnosed while incarcerated (AHR = 1.39, 95% CI = 1.12–1.73) and those recently released (AHR = 1.82, 95% CI = 1.57–2.10) compared to the never-incarcerated group. The risk for all-cause mortality was also higher for those diagnosed with cancer while incarcerated (AHR = 1.92, 95% CI = 1.63–2.26) and those recently released (AHR = 2.18, 95% CI = 1.94–2.45). There is a higher risk of cancer mortality among individuals diagnosed with cancer during incarceration and in the first-year post-release, which is not fully explained by stage of diagnosis. Cancer prevention and treatment efforts should target people who experience incarceration and identify why incarceration is associated with worse outcomes.
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