Luc Renault1, Emmanuel Perrot2, Eric Pradat3, Christophe Bartoli4,5, Laurent Greillier6,7, Anne Remacle-Bonnet8, Norbert Telmon9,10, Julien Mazières11,12, Laurent Molinier13,14, Sébastien Couraud15,16. 1. Faculté de Médecine Lyon Est, Université Lyon 1, 69008, Lyon, France. 2. Unité Hospitalière Sécurisée Interrégionale, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, 69310, Pierre Bénite, France. 3. Département d'Information Médicale, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, 69310, Pierre Bénite, France. 4. UMR 7268 ADES, CNRS, EFS, Aix-Marseille Université, 13284, Marseille, France. 5. Unité Hospitalière Sécurisée Interrégionale, Service de médecine en milieu pénitentiaire, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France. 6. Service Oncologie multidisciplinaire et innovations thérapeutiques, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France. 7. Aix Marseille Université, 13284, Marseille, France. 8. Service d'Information Médicale, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France. 9. Service de Médecine légale et pénitentiaire, Hôpital Rangueil, Centre Hospitalier Universitaire de Toulouse, 31059, Toulouse, France. 10. UMR 5288, CNRS, Faculté de Médecine Purpan, Université Toulouse III, 31000, Toulouse, France. 11. Service de pneumologie, Hôpital Larrey, Centre Hospitalier Universitaire de Toulouse, 31059, Toulouse, France. 12. Université Toulouse III - Paul Sabatier, 31062, Toulouse, France. 13. Département d'Information Médicale, Hôtel-Dieu Saint-Jacques, Centre Hospitalier Universitaire de Toulouse, 31059, Toulouse, France. 14. UMR 1027 INSERM - Université Toulouse III - Paul Sabatier, 31062, Toulouse, France. 15. Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, 165 chemin du grand Revoyet, 69310, Pierre Bénite, France. sebastien.couraud@chu-lyon.fr. 16. EMR3738 Ciblage thérapeutique en oncologie, Faculté de Médecine Lyon Sud-Charles Mérieux, Université Lyon 1, 69600, Oullins, France. sebastien.couraud@chu-lyon.fr.
Abstract
BACKGROUND: Few studies have looked at lung cancer in prisoners, despite this population is possibly at increased risk of malignancy. In a previous study, we found an early onset of lung cancer in prisoners. Thus, the present CARCAN study was aimed at assessing the epidemiological characteristics, management, prognosis, and incidence of lung cancer in prisoners compared to a sample of non-prisoner patients. METHOD: We performed a multi-center observational case-control study. Cases were prisoners diagnosed with lung cancer from 2005 to 2013. Controls were non-prisoner lung cancer patients selected from hospital databases and randomly matched to cases (targeted case-control ratio: 1:3). Incidence rates in both groups were calculated using national statistics. RESULTS: Seventy-two cases and 170 controls met inclusion criteria. Cases were mainly men (99%). Mean age at diagnosis was 52.9 (± 11.0) in cases and 64.3 (± 10.1) in controls (p < 0.0001). More case patients were current smokers compared to control patients (83% vs 53%; p < 0.0001). We found no significant differences between the two groups as concerns histologic types, TNM stages at diagnosis, initially-employed treatments, times to management or survival. Incidence rates (2008-2012) in male prisoners were higher than those in the general population in all concerned age groups. CONCLUSION: There is a shift of lung cancer toward young people in prisons. However, the presentation, management, and prognosis of lung cancer are similar between prisoners and non-prisoners. These finding could justify a specific screening policy for the incarcerated populations.
BACKGROUND: Few studies have looked at lung cancer in prisoners, despite this population is possibly at increased risk of malignancy. In a previous study, we found an early onset of lung cancer in prisoners. Thus, the present CARCAN study was aimed at assessing the epidemiological characteristics, management, prognosis, and incidence of lung cancer in prisoners compared to a sample of non-prisoner patients. METHOD: We performed a multi-center observational case-control study. Cases were prisoners diagnosed with lung cancer from 2005 to 2013. Controls were non-prisoner lung cancerpatients selected from hospital databases and randomly matched to cases (targeted case-control ratio: 1:3). Incidence rates in both groups were calculated using national statistics. RESULTS: Seventy-two cases and 170 controls met inclusion criteria. Cases were mainly men (99%). Mean age at diagnosis was 52.9 (± 11.0) in cases and 64.3 (± 10.1) in controls (p < 0.0001). More case patients were current smokers compared to control patients (83% vs 53%; p < 0.0001). We found no significant differences between the two groups as concerns histologic types, TNM stages at diagnosis, initially-employed treatments, times to management or survival. Incidence rates (2008-2012) in male prisoners were higher than those in the general population in all concerned age groups. CONCLUSION: There is a shift of lung cancer toward young people in prisons. However, the presentation, management, and prognosis of lung cancer are similar between prisoners and non-prisoners. These finding could justify a specific screening policy for the incarcerated populations.
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