Prisoners with cancer in England are more likely to die from it than other patients

Prisoners diagnosed with cancer are at greater risk than people in the general population of dying from the disease, research shows research.

A study has calculated that, compared with cancer patients in the general population, patients in English prisons are 28% less likely to need treatment for cancer, especially surgery to remove tumors, and have a 9% increased risk of death – with the half is due to cancer. to treatment differences.

It is believed to be the first study of cancer incidence, treatment and survival in an entire national prison population.

Researchers from King’s College London, the University of Surrey and University College London analyzed cancer data from the National Disease Registration Service for patients between 2012 and 2017. They compared the diagnosis, treatment and survival rates of 847 cancer patients in English prisons with 4,165 similar patients in the general population of the same age, gender, cancer type and stage.

They also interviewed prisoners with cancer, prison staff and healthcare professionals.

The research, published in three linked papers by the Lancet Oncology and eClinicalMedicine, found that only 27% of cancer patients in prison were diagnosed after a two-week urgent referral, compared with 37% in the general population. They were also three times less likely to be diagnosed through screening.

Once cancer was confirmed, one- and five-year survival rates were lower for those in prison, largely due to differences in treatment. Compared to cancer patients in the general population, 28% fewer prisoners underwent surgery, 21% less radiotherapy and 20% fewer systemic treatments such as chemotherapy or hormonal therapy.

The research has identified a number of them barriers to both diagnosis and treatment for patients in prison. These include lower health literacy, a complex process of getting to a GP and being late or missing hospital appointments due to prison staff shortages.

It was also harder for prisoners to follow their oncologist’s advice in managing and reporting any side effects from treatment, as they could not communicate with their advisers directly from prison, the study found.

The lead researcher, Dr Elizabeth Davies, a clinical reader in cancer and public health at King’s College London, said: “People in prison with cancer have until now been a hidden and under-researched population. They should not be affected by such health inequalities and should receive the same standard of care as in the community.”

Commenting on the findings, Dr Miranda Davies, a senior fellow at the Nuffield Trust, said: said: “It is so important to start cancer treatment early, so these findings showing that prisoners are less likely to undergo treatments such as tumor removal than cancer patients in the general population are shocking. Unfortunately, these findings represent only part of a broken system in which prisoners’ health care needs are systematically disrupted are regularly not met. Prisoners should have the same right and access to health care as everyone else, but this premise is far from reality.”

A government spokesperson said: “People in prison should receive the same standard and range of healthcare services as they do in the community, including cancer treatment. NHS England has one frame to reduce healthcare inequalities, both at national and system levels, including for those in contact with the criminal justice system. We will continue to work to improve pathways for offenders to access healthcare.”

An NHS spokesperson said: “The NHS is committed to ensuring that everyone in prison who has been diagnosed with cancer receives prompt and effective treatment, in line with community provision, and we continue to work with partner organizations of ways to make it easier for people to live in safe and secure conditions. incarcerated settings to access cancer and other health care services.”