Cancer screening in prisons: lessons for health providers

Background Lifestyle factors place those who experience incarceration at increased risk of morbidity and mortality from a range of preventable diseases, including cancer. Methods Two nurses were employed for a period of 6 months to facilitate bowel and breast cancer screening of prisoners across four correctional centres in Queensland. We identify factors impacting on cancer screening in prisons and document the outcomes for those screened. Results Both screening programs produced a positivity rate of ~17% in those screened, with 23 individuals returning a positive faecal occult blood test and five women requiring further investigations following breast screening. At 3 months postscreening, all of the positive cases had been referred for further investigations. It is likely that the screening programs were instrumental in preventing morbidity (and mortality) in the subgroup with positive test results. Conclusions Cancer screening within the prison environment presents a number of challenges. Intervention at the individual and systems level is required to ensure prisoners can access a standard of care equal to that provided in the community.