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Incarceration and Quality of Cancer Care.
Oluwadamilola T Oladeru1,2, Ilana B Richman3,4, Jenerius A Aminawung2,3
1Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida.
JAMA Network Open
|October 14, 2025
Summary
Individuals diagnosed with cancer during incarceration received lower quality and delayed cancer treatment. This highlights potential care gaps contributing to worse cancer outcomes for this population.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Incarceration is linked to poorer cancer outcomes, yet the quality of cancer care for individuals with a history of incarceration remains understudied.
- Understanding cancer care quality is crucial for addressing health disparities in this vulnerable population.
Purpose of the Study:
- To evaluate and describe the quality of cancer care received by individuals diagnosed with cancer during or immediately following incarceration.
- To compare cancer care quality across individuals with and without a history of incarceration.
Main Methods:
- A longitudinal cohort study utilized Connecticut Tumor Registry data linked with Department of Correction rosters (2005-2016).
- Patients diagnosed during incarceration were matched with those diagnosed post-incarceration and those with no incarceration history.
- Key outcomes included treatment initiation within 60 days and receipt of recommended pretreatment and therapeutic care, analyzed using logistic regression and chi-squared tests.
Main Results:
- Individuals diagnosed with cancer during incarceration were less likely to initiate treatment within 60 days compared to those with no incarceration history (OR, 0.49).
- Cancer treatment quality was significantly lower for those diagnosed during incarceration (49.2% of recommended care) and post-incarceration (45.3%) versus those with no history (66.7%).
- Pretreatment evaluation quality was similar across groups, but lower for those diagnosed during incarceration (80.6%) compared to post-incarceration (96.8%) and no history (78.1%).
Conclusions:
- Incarceration is associated with a reduced likelihood of receiving timely and high-quality cancer treatment.
- These findings suggest that disparities in cancer care quality may contribute to the observed worse cancer outcomes among individuals with a history of incarceration.
- Addressing care gaps during and after incarceration is essential for improving cancer care equity.
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