County Incarceration Linked to Elevated Cancer Mortality-to-Incidence Ratios

In an adjusted Poisson regression analysis, overall cancer incidence was negatively associated with county incarceration rate quartiles, with counties in the fourth incarceration quartile showing an incidence rate ratio of 0.97 (95% CI: 0.94–0.99). In adjusted linear regression models, the cancer mortality-to-incidence ratio was elevated in higher incarceration quartiles, with the fourth quartile exhibiting a coefficient of 0.018 (95% CI: 0.011–0.025). Similarly, the lung cancer-specific mortality-to-incidence ratio was elevated in higher incarceration quartiles, showing a coefficient of 0.024 (95% CI: 0.012–0.037) in the adjusted linear regression model.

The cross-sectional ecological study evaluated associations between county-level incarceration rates, cancer incidence, and the cancer mortality-to-incidence ratio to determine how differences in cancer incidence might contribute to previously reported links between county incarceration rates and cancer mortality. Researchers compiled publicly available data from 2017 to 2023 from the NIH State Cancer Profile, County Health Rankings, and the Vera Institute, comparing cancer incidence and mortality-to-incidence ratios across county incarceration quartiles using unadjusted and adjusted Poisson and linear regression models.

The observed associations were attenuated after controlling for state. The study authors concluded that the analysis indicates a complex relationship between county incarceration rates and cancer incidence, noting that elevated mortality-to-incidence ratios in high-incarceration counties suggest worse population-level cancer outcomes relative to cancer incidence that may be related to healthcare access disparities warranting further investigation.

Subject of Research: County-level incarceration rates and cancer incidence and mortality disparities

Article Title: Cancer disparities by county incarceration rate: an ecological analysis of county-level incarceration rates and cancer incidence and mortality

Article References: Siegel, M., Conley, B., Chui, K., Mathew, P., & Stopka, T. J. (2026). Cancer disparities by county incarceration rate: an ecological analysis of county-level incarceration rates and cancer incidence and mortality. Cancer Causes & Control, 37(11), Article 189. https://doi.org/10.1007/s10552-026-02269-3

Image Credits: AI Generated

DOI: 10.1007/s10552-026-02269-3

Keywords: cancer incidence, cancer mortality, county incarceration rates, mortality-to-incidence ratio, lung cancer, ecological study, health disparities, healthcare access, Cancer, disparities, county, incarceration