title: Liver cancer mortality among male prison inmates in Texas, 1992-2003.
abstract: OBJECTIVE
  Prevalence estimates for several liver cancer risk factors-hepatitis C, hepatitis B, and history of alcohol abuse-are substantially higher in U.S. prison populations than in the general population. However, liver cancer mortality data from these populations are lacking. The primary aims of this study were to examine trends in liver cancer mortality rates from 1992 to 2003 among male prisoners in the Texas Department of Criminal Justice (TDCJ) and to compare these rates to general population rates.
  
  
  METHODS
  TDCJ data on male decedents (N=4026) were linked with Texas Vital Statistics multiple-cause-of-death data. Crude average annual liver cancer death rates, average annual percent changes, and standardized mortality ratios were estimated.
  
  
  RESULTS
  Crude liver cancer death rates increased by an average annual 6.1% among male prisoners, which was considerably higher than the average annual percent change among similarly aged males in Texas (2.0%) and the U.S. (2.9%). The number of liver cancer deaths among male prisoners was 4.7 (4.0-5.6) and 6.3 (5.3-7.5) times higher than the expected number of deaths estimated using age-specific rates from these reference populations.
  
  
  CONCLUSIONS
  From 1992 to 2003, liver cancer death rates and rate increases were elevated among Texas male prisoners. Findings support previous recommendations for targeted prevention, screening, and treatment of liver cancer risk factors in prison populations.
authors.affiliation: Division of Epidemiology and Outcomes, Correctional Managed Care, University of Texas Medical Branch, Galveston, TX 77555, USA. ajharzke@utmb.edu
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Harzke
authors.forename: Jacques G
authors.initials: JG
authors.lastname: Baillargeon
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Goodman
authors.forename: Sandi L
authors.initials: SL
authors.lastname: Pruitt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D016001:Confidence Intervals; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016012:Poisson Distribution; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013781:Texas / Q000453:epidemiology