康涅狄格州成年人监禁与屏幕检出癌症诊断。
Incarceration and screen-detectable cancer diagnosis among adults in Connecticut.
机构信息
Cancer Outcomes, Public Policy, and Effectiveness Research, Yale School of Medicine, New Haven, CT, USA.
School of Social Work, University of Connecticut, Storrs, CT, USA.
出版信息
J Natl Cancer Inst. 2024 Mar 7;116(3):485-489. doi: 10.1093/jnci/djad242.
Although incarcerated adults are at elevated risk of dying from cancer, little is known about cancer screening in carceral settings. This study compared stage-specific incidence of screen-detectable cancers among incarcerated and recently released people with the general population, as a reflection of screening practices. We calculated the age- and sex-standardized incidence ratios (SIR) for early- and late-stage cancers for incarcerated and recently released adults compared to the general Connecticut population between 2005 and 2016. Our sample included 143 cancer cases among those incarcerated, 406 among those recently released, and 201 360 in the general population. The SIR for early-stage screen-detectable cancers was lower among incarcerated (SIR = 0.28, 95% CI = 0.17 to 0.43) and recently released (SIR = 0.69, 95% CI = 0.51 to 0.88) individuals than the general population. Incidence of late-stage screen-detectable cancer was lower during incarceration (SIR = 0.51, 95% CI = 0.27 to 0.88) but not after release (SIR = 1.32, 95% CI = 0.93 to 1.82). Findings suggest that underscreening and underdetection of cancer may occur in carceral settings.
尽管被监禁的成年人死于癌症的风险较高，但对于监禁环境中的癌症筛查知之甚少。本研究比较了监禁和最近释放的人群与一般人群中可通过筛查发现的癌症的特定阶段发病率，以反映筛查实践情况。我们计算了 2005 年至 2016 年期间，与康涅狄格州一般人群相比，监禁和最近释放的成年人的早期和晚期癌症的年龄和性别标准化发病率比（SIR）。我们的样本包括 143 例监禁人群中的癌症病例、406 例最近释放人群中的癌症病例和 201360 例一般人群中的癌症病例。与一般人群相比，监禁（SIR = 0.28，95%CI = 0.17 至 0.43）和最近释放（SIR = 0.69，95%CI = 0.51 至 0.88）人群中早期可通过筛查发现的癌症的 SIR 较低。在监禁期间，晚期可通过筛查发现的癌症的发病率较低（SIR = 0.51，95%CI = 0.27 至 0.88），但释放后则不然（SIR = 1.32，95%CI = 0.93 至 1.82）。这些发现表明，监禁环境中可能存在癌症筛查不足和漏诊的情况。
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