Breast and Colorectal Cancer Screening Utilization after Hurricane María and the COVID-19 Pandemic in Puerto Rico

Vivian Colón-López (), Héctor M. Contreras-Mora (), Cynthia M. Pérez, Hérmilis Berríos-Ortiz, Carola T. Sánchez-Díaz, Orville M. Disdier, Nilda Ríos-Morales and Erick L. Suárez-Pérez
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Vivian Colón-López: Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00927, USA
Héctor M. Contreras-Mora: Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00927, USA
Cynthia M. Pérez: Department of Biostatistics and Epidemiology, University of Puerto Rico Medical Sciences Campus, San Juan, PR 00936, USA
Hérmilis Berríos-Ortiz: Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00927, USA
Carola T. Sánchez-Díaz: Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute, New Brunswick, NJ 08901, USA
Orville M. Disdier: Puerto Rico Statistics Institute, San Juan, PR 00917, USA
Nilda Ríos-Morales: Puerto Rico Statistics Institute, San Juan, PR 00917, USA
Erick L. Suárez-Pérez: Department of Biostatistics and Epidemiology, University of Puerto Rico Medical Sciences Campus, San Juan, PR 00936, USA

IJERPH, 2023, vol. 20, issue 19, 1-14

Abstract: Puerto Rico (PR) has faced environmental and public health challenges that could have significantly affected cancer screening access. Using administrative claims data from PR’s Medicaid population, this study assessed trends in colorectal and breast cancer screening from 2016 to 2021, the impact of disasters in screening, and the absolute deficit in screening due to the pandemic. The monthly rates of claims were analyzed using Poisson regression. Significant reductions in breast and colorectal cancer screening utilization were observed. The colorectal cancer screening rate in 2017 was 77% lower a month after Hurricanes Irma and María [RR adj : 0.23; 95% CI: 0.20, 0.25] compared to the same time period in 2016. Breast cancer screening dropped 50% in November 2017 compared to November 2016 [RR adj : 0.50; 95% CI: 0.47, 0.54]. Prospectively, a recovery in utilization has been observed only for breast cancer screening. The results revealed that cancer screening utilization substantially declined after environmental disasters and the pandemic. These findings have potentially severe long-term implications for cancer health disparities and mortality in PR.

Keywords: breast cancer; colorectal cancer; COVID-19 pandemic; cancer screening (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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