Cancer Treatment Disruption by Residence Region in the Aftermath of Hurricanes Irma and María in Puerto Rico

Francisco Muñoz-Torres, Marievelisse Soto-Salgado, Karen J. Ortiz-Ortiz, Xavier S. López-León, Yara Sánchez-Cabrera and Vivian Colón-López ()
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Francisco Muñoz-Torres: Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00936, USA
Marievelisse Soto-Salgado: Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00936, USA
Karen J. Ortiz-Ortiz: Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00936, USA
Xavier S. López-León: Office of Community Outreach and Engagement, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00936, USA
Yara Sánchez-Cabrera: Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00936, USA
Vivian Colón-López: Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR 00936, USA

IJERPH, 2024, vol. 21, issue 10, 1-13

Abstract: Since 2017, Puerto Rico has faced environmental, economic, and political crises, leading to the emigration of healthcare workers and weakening the healthcare system. These challenges have affected cancer treatment continuity, exacerbating healthcare access challenges island-wide. In this study, we estimate the effect of the residence region on cancer treatment disruption following Hurricanes Irma and María (2017). Telephone surveys were conducted with 241 breast and colorectal cancer patients aged 40 and older who were diagnosed within six months before the hurricanes and were receiving treatment at the time of the hurricanes. Treatment disruption was defined as any pause in surgery, chemotherapy, radiotherapy, or oral treatment due to the hurricanes. Prevalence ratios (PRs) of treatment disruption by residence region were estimated using the San Juan Metropolitan Area (SJMA) as the reference. Fifty-nine percent of respondents reported treatment disruption; among them, half experienced disruptions lasting more than 30 days, with 14% of these enduring disruptions longer than 90 days. Adjusted models showed a 48% higher prevalence of disruption outside the SJMA (PR = 1.48, 95% CI: 1.06–2.07). Specific geographic regions (Arecibo, Bayamón, Caguas, and Mayagüez) exhibited higher disruption prevalence. These findings emphasize the need for disaster preparedness strategies that ensure equitable healthcare access for all cancer patients following environmental calamities.

Keywords: cancer patients; treatment disruption; healthcare access; Hispanics; disasters; Puerto Rico; hurricanes; regional disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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