Earlier onset and poor prognosis of lung cancer in imprisoned patients.

INTRODUCTION: Prison inmates are known to be more exposed to various lung cancer risk factors, and some studies have shown that lung cancer is the most common cancer in prisoners. However, no study has particularly focused on lung cancer features in this population. METHOD: Charts of patients with lung cancer hospitalized in one of the French secured hospital units between 1997 and 2012 were reviewed. Data from this cohort were then compared to those of two large observational studies conducted in 2000 and 2010 (KBP studies). RESULTS: Thirty-two cases were included. All were men. The mean age was 52.2 ± 11.5 years, which was significantly lower than in the KBP-2000 (64.4 years) and KBP-2010 (65.5 years; both p < 0.0001) studies. The percentage of current smokers was much higher in prisoners (87.1 vs. 52.2 and 49.2%, respectively; both p < 0.001). Ninety percent of prisoners presented with at least one comorbidity. Lung cancer clinical presentation did not differ between prisoners and the reference populations. The median overall survival was 5.8 months (range 0-15.1) for all stages and 4.7 months (range 2.8-6.6) for stage IIIB/IV. CONCLUSION: Although our study suffers from limitations, prisoners seem to develop lung cancer at a younger age and their prognosis is poor.

[How are palliative care needs estimated in short-stay establishments? Apropos of an experience in Côte d'Or]. / Comment estimer les besoins en soins palliatifs dans les établissements de court séjour? A propos d'une expérience en Côte d'Or.

The evaluation of needs and means concerning the care of patients in palliative treatment is among the problems seen as priority by the High Committee for Public Health. We have thus tried to characterise, in a specific health sector, the patients receiving palliative care in short-stay establishments in order to evaluate their care needs. We carried out an exhaustive descriptive survey among all public and private short-stay establishments in the Côte d'Or region. Of the 2116 patients in the hospital on the day of the survey, roughly 30% were considered as eligible for palliative care (patients suffering from serious, chronic and progressive illnesses). The average age of these patients is 63.9 years (standard deviation 19.7). They mainly suffer from tumours (50%), circulatory pathologies (15%), mental illness (7%), or neurological illnesses (6%). Among the patients that may need palliative care, 38% say they feel pain despite treatment with pain-killers among 25.3% of them. The personnel providing care is insufficiently trained in palliative care or in pain, as only a maximum of 18% of nurses and 5% of doctors in short-stay establishments have been trained in these areas.