Incarceration and Cancer-Related Outcomes (ICRO)

项目总结 美国是世界上被监禁人数最多的国家，其中大多数是 少数族裔群体和较低的社会经济地位。少数民族的高监禁率和 贫穷的人使得了解患有癌症的人的癌症流行病学尤为重要 监禁的历史和监禁对癌症差异的影响。具有以下历史的个人 监禁有较高的癌症危险因素比率，一些工作表明监禁史 与更高的癌症死亡率相关。然而，以前的工作并没有研究质量的影响 监禁对获得高质量癌症护理的机会，或监禁可能有助于 癌症差异。在解决这一知识鸿沟之前，我们将无法确定有效和持久的 减少在癌症发病率和死亡率方面观察到的差异的干预措施。这样做的长期目标是 应用的目的是减少癌症结果的差异。总体目标，这是迈向 实现这一长期目标，是评估监禁对癌症结局的影响和在 癌症检测、治疗质量和存活率。监禁和癌症的中心假说- 相关结果(ICRO)研究表明，监禁导致了#年的种族和社会经济差异。 癌症检测、治疗质量和死亡率。这项拟议研究的基本原理是 目前没有正在进行的或过去的癌症流行病学研究使我们能够衡量 对观察到的种族和社会经济差距的监禁。为了解决这一知识差距，我们将 创建首个肿瘤登记、矫正系统数据和州生命统计数据的全面链接 辅以深度访谈，对个体进行顺序解释性混合方法研究 得了癌症。我们将描述在有监禁历史的个人中癌症的负担 康涅狄格州的人口水平(目标1)。在康涅狄格州被诊断为癌症的居民中 (2005-2014)，我们将评估监禁与癌症死亡率之间的关系；癌症护理的质量； 以及监禁状况在多大程度上调节种族、社会经济地位和 癌症护理质量和死亡率(目标2-4)。然后，我们将使用这些数据为定性研究提供信息 关于在矫正系统和术后立即获得癌症护理的个人看法- 释放期(目标5)。ICRO将是第一个揭示人口水平的监禁可能是如何的研究 是造成种族和社会经济癌症差异的重要因素。本研究具有很强的创新性。 应用混合方法方法和构建新的数据链接来解决重要的问题 未充分研究监禁对观察到的种族和社会经济癌症的贡献问题 差距。总而言之，所产生的知识将产生积极影响，因为它将导致潜在的目标 干预措施，以改善数百万有监禁史的人的癌症结局。

PROJECT SUMMARY The United States has the largest number of individuals incarcerated in the world, the majority of whom are of racial and ethnic minority groups and lower socioeconomic status. Thehigh incarceration rate of minority and poorindividuals makes it especially important tounderstand the epidemiology of cancer among individuals with a history of incarceration and the impact of incarceration on cancer disparities. Individuals with a history of incarceration have higher rates of cancer risk factors, and some work has suggested that incarceration history is associated with a higher risk of cancer mortality. However, prior work has not examined the impact of mass incarceration on access to high quality cancer care, or the degree to which incarceration might contribute to cancer disparities. Until this knowledge gap is addressed, we will not be able to identify effective and durable interventions to mitigate observed disparities in cancer morbidity and mortality. The long-term goal of this application is to reduce disparities in cancer outcomes. The overall objective, which is a next step toward achieving this long-term goal, is to assess the impact of incarceration on cancer outcomes and disparities in cancer detection, quality of treatment, and survival. The central hypothesis of Incarceration and Cancer- Related Outcomes (ICRO) study is that incarceration contributes to racial and socioeconomic disparities in cancer detection, quality of treatment, and mortality. The underlying rationale for this proposed study is that there are currently no ongoing or past cancer epidemiologic studies that enable us to measure the contribution of incarceration on observed racial and socioeconomic disparities. To address this knowledge gap, we will create the first comprehensive linkage of a tumor registry, correctional system data, and state vital statistics supplemented with in-depth interviews, to conduct a sequential explanatory mixed methods study of individuals with cancer. We will describe the burden of cancer among individuals with a history of incarceration at the population level in Connecticut (Aim 1). And among Connecticut residents who are diagnosed with cancer (2005-2014), we will assess the relation between incarceration and cancer mortality; the quality of cancer care; and the degree to which incarceration status moderates the relation between race, socioeconomic status and quality of cancer care and mortality (Aim 2-4). We will then use these data to inform a qualitative study of individual perceptions regarding accessing cancer care in the correctional system and in the immediate post- release period (Aim 5). ICRO will be the first study to shed light on a population level how incarceration may be a substantive contributor to racial and socioeconomic cancer disparities. This study is highly innovative in its application of a mixed methods approach and construction of a novel data linkage to address the important yet understudied question of the contribution of incarceration on observed racial and socioeconomic cancer disparities. Together, the knowledge produced will have a positive impact, as it will result in potential targets for interventions to improve cancer outcomes among the millions of individuals with a history of incarceration.