February 23 2024
The largest and most contemporary study of incarcerated patients of its kind published this month in the Royal Australasian College of Physicians (RACP) Internal Medicine Journal, reveals that incarcerated cancer patients in Victoria are struggling to access life-saving treatment.
The study is the largest study of cancer in the prison population, tracking prisoners over a 15-year period.
Access to health care equivalent to that of the general population is a fundamental right of all prisoners. The data suggest that this is not occurring for prisoners with cancer in the state of Victoria.
“Our study showed that over time, cancer diagnoses in the prison population has increased rapidly. And wait times for prisoners to see a specialist were up to 30 weeks. It’s a problem that’s only getting worse,” says lead researcher Dr Genni M. Newnham.
“Our study also found the rate of documented mental illness in cancer patients increased from 32% to 54% over the same time period.
“77% of cancers were diagnosed only after patients had become symptomatic, and almost one-third had incurable disease at the time of diagnosis.
“We are seeing more and more prisoners with cancer who are in the over the age of 55, too – meaning there’s an ageing prison population with cancer and who are not getting access to the care they need.”
The study looked at three time periods of five years each: 2002 – 2006, 2007– 2011 and 2012 – 2016.
In the first time period, there were 31 cancer diagnoses with a median age of 45, whereas in the final time period of the study, there were 101 cancer diagnoses and a median age of 55.
“This indicates our prison population is aging and experiencing worse health outcomes.
The 15-year study identified 191 patients with cancer and evaluated their access to healthcare against Optimal Care Pathways (OCPs), which are Australia’s guidelines for best management for common cancer types.
Adherence to these guidelines is an indicator of the quality of healthcare delivery. The study found the range of adherence to OCPs was between 96% and 30%, indicating poor delivery of care for some cancer types.
“Our data demonstrates that our patients’ cancer was predominately exposure-related and diagnoses were often delayed, making management difficult and adding to the challenges of providing optimal care.
“Nonattendance was a huge issue for incarcerated patients, and although personal choice played a role in missed appointments, hospital practice and transport often impacted patients’ ability to make their appointments.
“Transport to and from appointments is a barrier for incarcerated patients. Travel is dependent on secure transport and guards, and with a growing prison population, the need for transport often exceeds availability.
“Personal choice also impacted nonattendance as a result of poor health literacy, competing priorities or personal safety concerns.
“There must be a concerted effort made by health and justice systems to improve the way cancer care is delivered to incarcerated patients.”