Grant Number:	5R01CA230444-03 Interpret this number
Primary Investigator:	Wang, Emily
Organization:	Yale University
Project Title:	Incarceration and Cancer-Related Outcomes (ICRO)
Fiscal Year:	2020

PROJECT SUMMARY The United States has the largest number of individuals incarcerated in the world, the majority of whom are of racial and ethnic minority groups and lower socioeconomic status. Thehigh incarceration rate of minority and poorindividuals makes it especially important tounderstand the epidemiology of cancer among individuals with a history of incarceration and the impact of incarceration on cancer disparities. Individuals with a history of incarceration have higher rates of cancer risk factors, and some work has suggested that incarceration history is associated with a higher risk of cancer mortality. However, prior work has not examined the impact of mass incarceration on access to high quality cancer care, or the degree to which incarceration might contribute to cancer disparities. Until this knowledge gap is addressed, we will not be able to identify effective and durable interventions to mitigate observed disparities in cancer morbidity and mortality. The long-term goal of this application is to reduce disparities in cancer outcomes. The overall objective, which is a next step toward achieving this long-term goal, is to assess the impact of incarceration on cancer outcomes and disparities in cancer detection, quality of treatment, and survival. The central hypothesis of Incarceration and Cancer- Related Outcomes (ICRO) study is that incarceration contributes to racial and socioeconomic disparities in cancer detection, quality of treatment, and mortality. The underlying rationale for this proposed study is that there are currently no ongoing or past cancer epidemiologic studies that enable us to measure the contribution of incarceration on observed racial and socioeconomic disparities. To address this knowledge gap, we will create the first comprehensive linkage of a tumor registry, correctional system data, and state vital statistics supplemented with in-depth interviews, to conduct a sequential explanatory mixed methods study of individuals with cancer. We will describe the burden of cancer among individuals with a history of incarceration at the population level in Connecticut (Aim 1). And among Connecticut residents who are diagnosed with cancer (2005-2014), we will assess the relation between incarceration and cancer mortality; the quality of cancer care; and the degree to which incarceration status moderates the relation between race, socioeconomic status and quality of cancer care and mortality (Aim 2-4). We will then use these data to inform a qualitative study of individual perceptions regarding accessing cancer care in the correctional system and in the immediate post- release period (Aim 5). ICRO will be the first study to shed light on a population level how incarceration may be a substantive contributor to racial and socioeconomic cancer disparities. This study is highly innovative in its application of a mixed methods approach and construction of a novel data linkage to address the important yet understudied question of the contribution of incarceration on observed racial and socioeconomic cancer disparities. Together, the knowledge produced will have a positive impact, as it will result in potential targets for interventions to improve cancer outcomes among the millions of individuals with a history of incarceration.




Incarceration and Screen-Detectable Cancer Diagnosis among Adults in Connecticut.
Authors: Richman I.B. , Soulos P.R. , Lin H. , Aminawung J.A. , Oladeru O.T. , Puglisi L.B. , Wang E.A. , Gross C.P. .
Source: Journal Of The National Cancer Institute, 2023-11-22 00:00:00.0; , .
EPub date: 2023-11-22 00:00:00.0.
PMID: 37991935
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Cancer incidence among incarcerated and formerly incarcerated individuals: A statewide retrospective cohort study.
Authors: Aminawung J.A. , Soulos P.R. , Oladeru O.T. , Lin H.J. , Gonsalves L. , Puglisi L.B. , Hassan S. , Richman I.B. , Wang E.A. , Gross C.P. .
Source: Cancer Medicine, 2023-05-29 00:00:00.0; , .
EPub date: 2023-05-29 00:00:00.0.
PMID: 37248772
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Medication Access in Prisons and Jails-Some Answers, More Questions.
Authors: Hawks L. , Wang E. .
Source: Jama Health Forum, 2023-04-07 00:00:00.0; 4(4), p. e230167.
EPub date: 2023-04-07 00:00:00.0.
PMID: 37058295
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Neighborhood Incarceration Rates and Adverse Birth Outcomes in New York City, 2010-2014.
Authors: Holaday L.W. , Tolliver D.G. , Moore T. , Thompson K. , Wang E.A. .
Source: Jama Network Open, 2023-03-01 00:00:00.0; 6(3), p. e236173.
EPub date: 2023-03-01 00:00:00.0.
PMID: 37000451
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Incarceration status and cancer mortality: A population-based study.
Authors: Oladeru O.T. , Aminawung J.A. , Lin H.J. , Gonsalves L. , Puglisi L. , Mun S. , Gallagher C. , Soulos P. , Gross C.P. , Wang E.A. .
Source: Plos One, 2022; 17(9), p. e0274703.
EPub date: 2022-09-16 00:00:00.0.
PMID: 36112653
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Association of census tract-level incarceration rate and life expectancy in New York State.
Authors: Holaday L.W. , Howell B. , Thompson K. , Cramer L. , Wang E.A. .
Source: Journal Of Epidemiology And Community Health, 2021 10; 75(10), p. 1019-1022.
EPub date: 2021-04-27 00:00:00.0.
PMID: 33906904
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Changes In Health Services Use After Receipt Of Medications For Opioid Use Disorder In A Statewide Correctional System.
Authors: Howell B.A. , Martin R.A. , Lebeau R. , Truong A.Q. , Wang E.A. , Rich J.D. , Clarke J.G. .
Source: Health Affairs (project Hope), 2021 08; 40(8), p. 1304-1311.
PMID: 34339247
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Incarceration and Cancer-Related Outcomes (ICRO) study protocol: using a mixed-methods approach to investigate the role of incarceration on cancer incidence, mortality and quality of care.
Authors: Puglisi L. , Halberstam A.A. , Aminawung J. , Gallagher C. , Gonsalves L. , Schulman-Green D. , Lin H.J. , Metha R. , Mun S. , Oladeru O.T. , et al. .
Source: Bmj Open, 2021-05-25 00:00:00.0; 11(5), p. e048863.
EPub date: 2021-05-25 00:00:00.0.
PMID: 34035109
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Service Involvement Across Multiple Sectors Among People Who Use Opioids, Methamphetamine, or Both, United States-2015-2018.
Authors: Howell B.A. , Bart G. , Wang E.A. , Winkelman T.N.A. .
Source: Medical Care, 2021-03-01 00:00:00.0; 59(3), p. 238-244.
PMID: 33165146
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Expanding access to methadone treatment in Ohio through federally qualified health centers and a chain pharmacy: A geospatial modeling analysis.
Authors: Iloglu S. , Joudrey P.J. , Wang E.A. , Thornhill T.A. , Gonsalves G. .
Source: Drug And Alcohol Dependence, 2021-03-01 00:00:00.0; 220, p. 108534.
EPub date: 2021-01-19 00:00:00.0.
PMID: 33497963
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Effectiveness of interventions to reduce COVID-19 transmission in a large urban jail: a model-based analysis.
Authors: Malloy G.S.P. , Puglisi L. , Brandeau M.L. , Harvey T.D. , Wang E.A. .
Source: Bmj Open, 2021-02-17 00:00:00.0; 11(2), p. e042898.
EPub date: 2021-02-17 00:00:00.0.
PMID: 33597139
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Cancer Prevalence Among Adults with Criminal Justice Involvement from a National Survey.
Authors: Puglisi L.B. , Winkelman T.N.A. , Gross C.P. , Wang E.A. .
Source: Journal Of General Internal Medicine, 2019-07-18 00:00:00.0; , .
EPub date: 2019-07-18 00:00:00.0.
PMID: 31321602
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