Less Than Half of Incarcerated Population Receives Recommended Cancer Care

Although about a third of the general population may not receive guideline-concordant care for cancer, more than half of patients incarcerated or recently released did not receive recommended care, highlighting severe gaps in accessing effective treatment among these populations.

In an interview with CancerNetwork®, Cary P. Gross, MD, professor of General Medicine and Epidemiology, as well as the founder and director of the Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center at the Yale School of Medicine, discussed findings from a study he coauthored and published in JAMA Network Open. The study explored the disparities in the quality of care between the general population and currently or recently incarcerated individuals undergoing treatment for their cancers.

Gross began by highlighting a relationship between history of incarceration and a lower quality of care among patients undergoing cancer treatment, with 49% of patients who were incarcerated at cancer diagnosis and 45% of those diagnosed within 1 year of release receiving guideline-concordant care vs 67% of the general population. Furthermore, Gross postulated that among all populations, there is a significant need for greater access to quality care, and that for the incarcerated population his team examined, underlying challenges related to accessing care and social determinants of health may could present as barriers.

Transcript:

What we found was that there was a relation between incarceration history and the quality of care. What we did was we matched [patients] who had been diagnosed with cancer in a certain time frame according to where they were diagnosed. What we found was that, broadly speaking, [for] people who were diagnosed during incarceration, about half of them received the care that was recommended for them [across] different types of cancer, breast, lung, prostate, et cetera; half of [patients] diagnosed during incarceration. But we found amongst people who were incarcerated but diagnosed afterward—the year after incarceration—only 45% were getting the recommended care. Both of those groups, 49% while incarcerated [and] 45% after incarceration, ended up having a lower likelihood of getting recommended care than people who are diagnosed out in the community; that group was 67%.

There are 2 main findings [or] 2 main inferences here. First, if you leave incarceration, leave that bucket to the side for a second, and focus on the broader population here in Connecticut, 67% [or] only two-thirds of [patients] are getting all of the care that’s recommended for them. [With] guideline-concordant care overall in the general population, there’s plenty of room for improvement. Now, the other 2 groups [with] current or recent incarceration, both of them had a lower quality of care, and that suggests that maybe it’s not the issue of whether someone’s currently incarcerated; maybe the underlying social challenges and challenges [with] accessing health care that may be associated with incarceration are driving some of these challenges to access and care.

Two take home points: there is a relation between incarceration and lower quality of care, but it’s not just because you are incarcerated. Again, because we think that the same factors that are associated with incarceration—such as less likelihood of having health insurance or being exposed to racism, a lack of feeling comfortable or welcome, or obtaining high quality care in the health system—could be barriers. The other major take home point is that in the larger population, there are gaps for everyone in getting the quality of care that [they] need.

Reference

Oladeru OT, Richman IB, Aminawung JA, et al. Incarceration and quality of cancer care. JAMA Netw Open. 2025;8(10):e2537400. doi:10.1001/jamanetworkopen.2025.37400