The Department of Justice Office of the Inspector General (DOJ OIG) has released a report evaluating the Federal Bureau of Prisons' (BOP) colorectal cancer screening practices for inmates and the clinical follow-up on positive screenings. The report highlights several operational and managerial deficiencies that need to be addressed to ensure proper screening and treatment for inmates.
Inspector General Michael E. Horowitz said, "The failure to provide annual CRC screenings as directed by BOP clinical guidance creates higher risks and potentially poorer clinical outcomes for inmates and can result in substantially increased healthcare costs for the BOP."
The evaluation was initiated following issues identified during prior unannounced inspections of BOP institutions, as well as the deaths from colorectal cancer of two inmates, Robert Hanssen and Frederick Bardell. Former FBI agent Robert Hanssen died of metastatic colon cancer in June 2023 after multiple positive CRC screening results while incarcerated but without receiving a colonoscopy or diagnosis. Frederick Bardell died in February 2021, nine days after being released from BOP custody following a compassionate release order. He had reported seeing blood in his stool but faced significant delays in follow-up care.
The OIG has also started an investigation into the circumstances surrounding Bardell's release from prison and subsequent death. "When our investigation is concluded, we will proceed with our usual process for releasing our findings publicly in accordance with relevant laws and DOJ and OIG policies," said Horowitz.
Key findings from the evaluation include that less than two-thirds of average-risk inmates aged 45 through 74 were offered an annual CRC screening, with less than half having a current annual screening as of April 2024. Screening offer rates varied widely by facility. Additionally, about 10 percent of inmates had no documented follow-up after a positive CRC screening result, with long wait times averaging eight months for a colonoscopy following a positive result.
The report also noted gaps in identifying, monitoring, and documenting increased-risk inmates due to limitations within the BOP’s Electronic Medical Records System (BEMR). This affects the ability to ensure appropriate screenings for increased-risk inmates.
The OIG made 13 recommendations to address these issues, all of which were agreed upon by the BOP.
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