Socio-demographic factors, tumor characteristics, treatments administered, and survival in cancer patients in a prison hospitalization unit: a retrospective cohort comparison with matched community controls.

BACKGROUND

Cancer significantly contributes to morbidity and mortality among incarcerated populations globally, yet research on cancer characteristics and outcomes in this vulnerable group remains limited. The purpose of this study is to compare sociodemographic factors, main tumor characteristics, treatment modalities, and survival rates between cancer patients managed within a prison hospitalization unit (PHU) and those treated in a community hospital.

METHODS

A retrospective cohort study was conducted, comparing 63 cancer patients from the PHU with 129 matched controls from the general population, matched by tumor type and age. Sociodemographic variables, risk factors, tumor types, treatment and survival were analyzed. Chi-square tests and Student's t tests were used for group comparisons, and Kaplan-Meier curves with log-rank tests were applied for survival analysis. The statistical significance level considered was 5% (SPSS v29).

RESULTS

The prison population had a higher prevalence of smoking (74.6% vs. 60.5%), alcohol consumption (50.8% vs. 36.4%), and other substance use (25.4% vs. 14.7%) (p < 0.001). The most common types of tumors were gastrointestinal (12%), prostate (9%), and head and neck (9%). Survival was lower for head/neck cancer patients in the PHU and higher in lung cancer patients (p < 0.005).

CONCLUSIONS

Incarcerated cancer patients presented a higher prevalence of risk factors but received similar oncological treatments compared to community controls. Survival was poorer for head and neck cancers and unexpectedly better for lung cancer, although these findings should be interpreted cautiously due to the small sample size. The integrated prison-hospital model may reduce treatment disparities, but barriers to early diagnosis and follow-up remain.