The US jails more people than any other country. A new study shows very high cancer rates in this group. It appears that 30% of incarcerated adults die of cancer. They are also more likely to get gut (gastrointestinal) cancer than other groups. So researchers say incarcerated adults need better access to cancer screening to catch it early. People who have been to prison should also know they face a higher cancer risk.
The US has the most people in prison at any given time, with more than 2 million held. That means several million people have spent at least some time locked up. Not all of them are there for serious crimes. Studies suggest people who have spent time in prison face a higher risk of some health conditions. These include complex regional pain syndrome and chronic pain.
These numbers are huge. So it is vital to understand the health risks in this group. Sadly, it is also one of the most neglected groups. But now a new study shows that incarcerated people are at a much greater risk of dying from cancer than people who were never imprisoned. In fact, cancer is the leading cause of death in people who have spent time in prison. Studies suggest almost 30% of all deaths in incarcerated people are from cancer. That is far higher than in the general population.
The problem is that incarcerated people are more likely to die of cancer even when they are out of prison. To confirm this, researchers studied data from the cancer registry. They looked at all cancer cases from 2005 to 2016. Cancer was almost 50% more common in this group. And they were almost twice as likely to die from invasive cancer as other people. Most people do not think of this group as high-risk for cancer. They think of infections, substance abuse, metabolic disorders, and other problems. But it appears that even some time in prison raises cancer risk a lot.
There may be many reasons for the higher cancer risk and lower survival. It could be high stress, poor medical care, bad diet, and more. Being locked up also means less movement and fewer comforts. Studies also show the cancer pattern is different in incarcerated people. They are most likely to get cancer of the gut, followed by lung, prostate, leukemia, and lymphoma.
Some reasons are easy to see. In prison, there is no access to high-quality medical care. That means chronic health problems are poorly treated. It also means cancer and other diseases are diagnosed late. Incarcerated people may also miss proper treatment and comfort (palliative) care. That may explain the much higher cancer death rate in this group.
The truth is that researchers still do not fully know why incarcerated people get more cancer. So researchers say their study also shows why we need transition centers for people leaving prison. These would remove some barriers to catching cancer early. They would also ensure better primary care, steady food, and jobs. And they would help people rejoin society.
Researchers say cancer screening must be part of primary care for people just released from detention. These findings matter most for policymakers, who need to make big changes in the prison system. Cancer is now the leading cause of disease and death in this group.
Frequently asked questions
What happens if you get cancer in prison?
Too often, it is found late and treated poorly. Prisons lack high-quality medical care. So chronic conditions go undertreated and cancer is diagnosed late. Incarcerated people may also miss proper cancer treatment and comfort care. Put together, those gaps help explain why cancer kills this group at a much higher rate than people who were never imprisoned.
What is the leading cause of death among people who have been in prison?
Cancer. It is the leading cause of death in people who have spent time in prison. It accounts for almost 30% of all deaths in incarcerated people. That share is much higher than in the general population. Many people assume infections, substance abuse or metabolic disorders are the bigger threat to this group. Cancer is the one that kills most often.
Which cancers are most common in incarcerated people?
Cancers of the gut lead, followed by lung cancer, prostate cancer, leukemia and lymphoma. That pattern differs from the general population. And it matters for screening. A doctor caring for someone who has been in prison should know which cancers to look for first.
Does the higher cancer risk continue after release from prison?
Yes. Incarcerated people are more likely to die of cancer even when they are out of prison. Registry data on cancer cases from 2005 to 2016 showed cancer almost 50% more common in this group. They had nearly twice the risk of dying from invasive cancer. Researchers want cancer screening built into primary care for people just released. They also want transition centers that remove barriers to early diagnosis.
Why are incarcerated people at higher risk of cancer?
Researchers do not fully know yet. Likely drivers include high stress, poor medical care, poor diet, and less movement while locked up. Late diagnosis once cancer starts adds to it. Even a short time in prison seems to raise cancer risk a lot. So anyone who has been in prison should know about the higher risk and ask about screening.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
