{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:03:37Z","timestamp":1793070217182,"version":"4.5.0"},"reference-count":22,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi251038-4\"><jats:title>Importance<\/jats:title><jats:p>Individuals diagnosed with cancer while incarcerated in US prisons have worse mortality than nonincarcerated individuals. Incarceration poses numerous barriers to care, and optimal strategies to improve cancer screening, diagnosis, and treatment are needed.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251038-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate perspectives among correctional health and oncology clinicians on strategies to improve cancer care in US prisons, from screening and diagnosis to treatment and end-of-life care.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251038-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This qualitative study conducted interviews across 16 US state and federal prisons systems between September 2023 and April 2024 and a member-checking focus group in February 2025. Semistructured interviews were conducted with prison medical directors, primary care clinicians, and oncologists involved in delivering cancer care for individuals incarcerated in US prisons. Participants were recruited via email invitation sent to attendees of a correctional health conference, purposeful sampling using targeted emails to clinicians in diverse prison systems, and snowball sampling of individuals from research and participant networks. Interview transcripts were analyzed to identify all recommended strategies for improving care across the cancer care continuum. Data were analyzed from September 2023 to February 2025.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251038-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>To identify recommendations on tools, practices, or policies to improve cancer care (hereafter, <jats:italic toggle=\"yes\">strategies<\/jats:italic>) for incarcerated patients with cancer.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251038-8\"><jats:title>Results<\/jats:title><jats:p>A total of 32 participants from 16 prison systems were interviewed (median [range] age, 49 [33 to \u226570] years; 20 female [62.5%]; 6 Asian or Pacific Islander [18.8%], 5 Black [15.6%], and 21 White [65.6%]), including 9 medical directors, 6 primary care physicians, and 15 oncologists. Participants identified strategies to improve care addressing nearly all previously identified barrier themes, including strategies for (1) conducting screening in prisons; (2) bringing cancer treatment into prisons and centralizing care; (3) using telehealth, navigators, and early oncologist involvement to improve care coordination; (4) improving communication and social support; (5) improving symptom management, access to palliative medicine, and end-of-life care; and (6) delivering patient-centered care. Strategies require implementation by prisons, prison clinicians, oncologists, oncology practices, and policymakers. A total of 22 focus group participants reinforced these strategies with additional supportive insights.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi251038-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this qualitative study of clinicians delivering cancer care for incarcerated individuals, participants identified pragmatic strategies to improve cancer screening and treatment that address most identified barriers to care in US prisons. Application of these strategies may be associated with mitigation of disparities in cancer survival for incarcerated individuals.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.37640","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T15:01:47Z","timestamp":1760540507000},"page":"e2537640","source":"Crossref","is-referenced-by-count":4,"title":["Correctional Health and Oncologist Perspectives on Strategies to Improve Cancer Care in US Prisons"],"prefix":"10.1001","volume":"8","author":[{"given":"Christopher R.","family":"Manz","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Nava-Coulter","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Voligny","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Gundersen","sequence":"additional","affiliation":[{"name":"Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, New Jersey"},{"name":"Department of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexi A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"issue":"20","key":"zoi251038r2","doi-asserted-by":"publisher","first-page":"7277","DOI":"10.1002\/cam4.4251","article-title":"Disparities in cancer prevalence, incidence, and mortality for incarcerated and formerly incarcerated patients: a scoping review.","volume":"10","author":"Manz","year":"2021","journal-title":"Cancer Med"},{"issue":"9","key":"zoi251038r3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0274703","article-title":"Incarceration status and cancer mortality: a population-based study.","volume":"17","author":"Oladeru","year":"2022","journal-title":"PLoS One"},{"issue":"5","key":"zoi251038r4","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/S1470-2045(24)00035-4","article-title":"Cancer incidence, treatment, and survival in the prison population compared with the general population in England: a population-based, matched cohort study.","volume":"25","author":"L\u00fcchtenborg","year":"2024","journal-title":"Lancet Oncol"},{"key":"zoi251038r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102540","article-title":"Cancer in prison: barriers and enablers to diagnosis and treatment.","volume":"72","author":"Armes","year":"2024","journal-title":"EClinicalMedicine"},{"issue":"10","key":"zoi251038r7","article-title":"Barriers and facilitators to delivering cancer care in US prisons.","volume":"8","author":"Manz","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"9","key":"zoi251038r8","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.2105\/AJPH.2006.102525","article-title":"Approaching health disparities from a population perspective: the National Institutes of Health Centers for Population Health and Health Disparities.","volume":"98","author":"Warnecke","year":"2008","journal-title":"Am J Public Health"},{"issue":"3","key":"zoi251038r10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/HYRT9622","article-title":"Cancer in English prisons: a mixed-methods study of diagnosis, treatment, care costs and patient and staff experiences.","volume":"13","author":"Davies","year":"2025","journal-title":"Health Soc Care Deliv Res"},{"issue":"22","key":"zoi251038r11","doi-asserted-by":"publisher","first-page":"3930","DOI":"10.1002\/cncr.29610","article-title":"Patient navigation as a targeted intervention: for patients at high risk for delays in cancer care.","volume":"121","author":"Freeman","year":"2015","journal-title":"Cancer"},{"issue":"5","key":"zoi251038r12","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1007\/s11912-024-01514-9","article-title":"Patient navigation in cancer treatment: a systematic review.","volume":"26","author":"Chen","year":"2024","journal-title":"Curr Oncol Rep"},{"issue":"1","key":"zoi251038r16","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1186\/s12889-024-17715-7","article-title":"Interventions for the detection, monitoring, and management of chronic non-communicable diseases in the prison population: an international systematic review.","volume":"24","author":"Hewson","year":"2024","journal-title":"BMC Public Health"},{"issue":"1","key":"zoi251038r18","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/1078345807309616","article-title":"Thirty years after Estelle v. Gamble: a legal retrospective.","volume":"14","author":"Rold","year":"2008","journal-title":"J Correct Health Care"},{"issue":"9","key":"zoi251038r19","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1056\/NEJMms2211252","article-title":"Health care in U.S. correctional facilities\u2014a limited and threatened constitutional right.","volume":"388","author":"Alsan","year":"2023","journal-title":"N Engl J Med"},{"issue":"1","key":"zoi251038r20","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1089\/jchc.24.06.0046","article-title":"Lung cancer screening in the incarcerated population through a community imaging partnership.","volume":"31","author":"Healey","year":"2025","journal-title":"J Correct Health Care"},{"key":"zoi251038r21","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102575","article-title":"Does the cost of cancer care for people in prison differ from those in the general population: analysis of matched English cancer registry and hospital records.","volume":"72","author":"Hunter","year":"2024","journal-title":"EClinicalMedicine"},{"key":"zoi251038r9","volume-title":"Qualitative Inquiry and Research Design: Choosing Among Five Approaches","author":"Creswell","year":"2007","edition":"2nd ed"},{"key":"zoi251038r17","year":"1976"},{"key":"zoi251038r1","unstructured":"Carson? EA, Cowhig? MP. Mortality in state and federal prisons, 2001-2016\u2014statistical tables. 2020. Accessed September 10, 2025. https:\/\/www.bjs.gov\/content\/pub\/pdf\/msfp0116st.pdf"},{"key":"zoi251038r6","unstructured":"Pollitt? A, Pow? R, Moxham-Hall? V, . Improving cancer care in prisons. 2024. Accessed September 10, 2025. https:\/\/openresearch.surrey.ac.uk\/esploro\/outputs\/report\/Improving-cancer-care-in-prisons\/99883666302346#file-0"},{"key":"zoi251038r13","unstructured":"Louisiana House of Representatives 2021 House Resolution 51 Task Force. Medical release from incarceration: A study of compassionate release, parole, and furlough. 2022. Accessed September 10, 2025. https:\/\/static1.squarespace.com\/static\/5fe0e9cce6e50722511b03cc\/t\/623b58a73829ce5f679a342c\/1648056493113\/2022.02.25+HR51+TASK+FORCE+REPORT.pdf"},{"key":"zoi251038r14","unstructured":"US Sentencing Commission. Compassionate release data reports. Accessed December 11, 2024. https:\/\/www.ussc.gov\/research\/data-reports\/compassionate-release-data-reports"},{"key":"zoi251038r15","unstructured":"Families Against Mandatory Minimums. Grading the states: the state compassionate release report card project. 2022. Accessed September 10, 2025. https:\/\/famm.org\/wp-content\/uploads\/2022\/10\/compassionate-release-report.pdf"},{"key":"zoi251038r22","unstructured":"Carson? EA. Mortality in local jails, 2000-2018\u2014statistical tables. 2021. Accessed September 10, 2025. https:\/\/bjs.ojp.gov\/library\/publications\/mortality-local-jails-2000-2018-statistical-tables"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2840137\/manz_2025_oi_251038_1759861254.14873.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T15:01:50Z","timestamp":1760540510000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2840137"}},"subtitle":["A Qualitative Study"],"short-title":[],"issued":{"date-parts":[[2025,10,15]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.37640","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,15]]}}}