About this trial
Prostate cancer is the most common cancer affecting men in the UK and is the most common cancer in UK prisons.
Early diagnosis is vital because treatment is more effective when the disease is detected at an early stage. However, people in prison face significant barriers to healthcare, and little is known about how prostate cancer affects this population. This is concerning, as the prison population is ageing, and men over 50 are at the highest risk of developing prostate cancer.
Research shows that prisoners are more likely to be diagnosed with any cancer at a late stage, often through emergency hospital visits, and are less likely to receive timely or curative treatment compared to the general population. Survival rates are also worse. However, there are very little data from the UK describing prostate cancer diagnosis and outcomes in the UK from the prison population, which is why we want to find out information about prostate cancer diagnosis in prisons compared to in the general population.
This project, a collaboration between Oxleas NHS Trust and The Royal Marsden, will test and develop processes for extracting pseudo-anonymised data from the prison population. Using pseudo-anonymous data from prisoner health records in Oxleas NHS Trust, we will assess prevalence and examine how prostate cancer is diagnosed, the treatments offered, and the survival outcomes. We will compare these results against UK Genetic Prostate Cancer Study (UKGPCS) data about men of a similar age in the general population. Our aim is to understand whether prisoners face delays in diagnosis and worse outcomes, and to assess whether prison-based screening could help.
The findings will inform future healthcare research and the development of policies and may support the development of tailored educational resources and screening approaches, ultimately helping to reduce health inequalities and improve outcomes for people in prison.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adult men (over 18 years of age) and people with prostates in the UK prison population with healthcare under Oxleas NHS Trust (sample includes 13 prisons under Oxleas NHS Trust with 9,007 adult men).
Full data extraction will only occur for prisoners who have been diagnosed with prostate cancer while in the custody of His Majesty's Prison Service. The number of prisoners living with a diagnosis of prostate cancer will be noted, but no further data extraction will take place if diagnosed outside of prison.
age at diagnosis
method of diagnosis (screening/ 2WR (symptomatic)/ emergency),
Disqualifiers
Although the number of prisoners living with a diagnosis of prostate cancer will be noted, those who were diagnosed with prostate cancer outside of their prison stay will not undergo further data extraction for data around diagnosis and outcomes.
Potential participants who have opted out via the NHS England National Data Opt-Out (NDOO) service and therefore their data will not be used.
Trial population
Men diagnosed with prostate cancer while in the care of His Majesty's Prison Service, are less likely to be diagnosed from screening and more likely to be diagnosed with late-stage disease, compared to that in the general population. In addition they are at risk of less favourable outcomes in terms of curative treatment and survival, compared to the general population.
Trial design
Other
Retrospective
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
Prevalence, method of diagnosis, stage at diagnosis, outcomes of prostate cancer in the Oxleas NHS prison population
Prevalence statistics from the number of adult men and people with prostates in the prison population under Oxleas NHS Foundation Trust, who are identified as living with a diagnosis of prostate cancer. For those who received the diagnosis in prison, data will be collected form their electronic health record to include PSA at diagnosis, method of diagnosis (diagnosed through PSA screening, symptomatic presentation via primary care/2-week-wait referral, emergency presentation), stage and grade at diagnosis and time intervals between referral and diagnosis and treatment received.
Secondary outcomes
How does the primary outcome data compare to the general population included in the UKGPCS dataset
Comparison between prostate cancer diagnosis, treatment and outcome data collected from the prison population with age and ethnicity matched individuals in the general population from the UKGPCS dataset, using statistical analysis to present findings.
Sponsors and contacts
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Royal Marsden NHS Foundation Trust
Lead sponsor
Public Health England
Collaborator
The Institute of Cancer Research, Sutton, Surrey, UK
Collaborator
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