title: Exploring barriers to and enablers of adequate healthcare for Indigenous Australian prisoners with cancer: a scoping review drawing on evidence from Australia, Canada and the United States.
abstract: BACKGROUND
  International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group.
  
  
  METHODS
  This scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation.
  
  
  RESULTS
  Eight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons' concern with security versus the need for timely access to medical care.
  
  
  CONCLUSIONS
  Findings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians' over-burden of cancer mortality and over-representation in the prison system, further research is needed to identify whether there are a unique set of barriers for this group.
authors.affiliation: Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Olds
authors.affiliation: Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Reilly
authors.affiliation: Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Yerrell
authors.affiliation: Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Stajic
authors.affiliation: Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Micklem
authors.affiliation: Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Morey
authors.affiliation: Wardliparingga, South Australian Health and Medical Research Institute, Nort Terrace, 5000 Adelaide, Australia ; Centre for Population Health Research, University of South Australia, Adelaide, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Brown
keywords: Aboriginal; Access; Barriers; Cancer; Healthcare; Prisoners