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Ortiz AP, Hospedales CJ, Méndez-Lázaro PA, Hamilton WM, Rolle LD, Shepherd JM, Espinel Z, Gay HA, Nogueira LM, Shultz JM. Protecting Caribbean patients diagnosed with cancer from compounding disasters. Lancet Oncol 2024; 25:e217-e224. [PMID: 38697167 DOI: 10.1016/s1470-2045(24)00071-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 05/04/2024]
Abstract
Caribbean small island developing states are becoming increasingly vulnerable to compounding disasters, prominently featuring climate-related hazards and pandemic diseases, which exacerbate existing barriers to cancer control in the region. We describe the complexities of cancer prevention and control efforts throughout the Caribbean small island developing states, including the unique challenges of people diagnosed with cancer in the region. We highlight potential solutions and strategies that concurrently address disaster adaptation and cancer control. Because Caribbean small island developing states are affected first and worst by the hazards of compounding disasters, the innovative solutions developed in the region are relevant for climate mitigation, disaster adaptation, and cancer control efforts globally. In the age of complex and cascading disaster scenarios, developing strategies to mitigate their effect on the cancer control continuum, and protecting the health and safety of people diagnosed with cancer from extreme events become increasingly urgent. The equitable development of such strategies relies on collaborative efforts among professionals whose diverse expertise from complementary fields infuses the local community perspective while focusing on implementing solutions.
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Affiliation(s)
- Ana Patricia Ortiz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico; Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - C James Hospedales
- EarthMedic and EarthNurse Foundation for Planetary Health, Port of Spain, Trinidad and Tobago; Defeat-NCD Partnership Executive Committee Climate and Health, Healthy Caribbean Coalition, Geneva, Switzerland
| | - Pablo A Méndez-Lázaro
- Environmental Health Department, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | | | - LaShae D Rolle
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - J Marshall Shepherd
- Institute for Resilient Infrastructure Systems, Department of Geography, University of Georgia, Athens, GA, USA
| | - Zelde Espinel
- Department of Psychiatry and Behavioral Sciences, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hiram A Gay
- Department of Radiation Oncology, School of Medicine, Washington University in St Louis, Saint Louis, MO, USA
| | | | - James M Shultz
- Protect & Promote Population Health in Complex Crises, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
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2
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Nogueira L, Florez N. The Impact of Climate Change on Global Oncology. Hematol Oncol Clin North Am 2024; 38:105-121. [PMID: 37580192 DOI: 10.1016/j.hoc.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Climate change is the greatest threat to human health of our time, with significant implications for global cancer control efforts. The changing frequency and behavior of climate-driven extreme weather events results in more frequent and increasingly unanticipated disruptions in access to cancer care. Given the significant threat that climate change poses to cancer control efforts, oncology professionals should champion initiatives that help protect the health and safety of patients with cancer, such as enhancing emergency preparedness and response efforts and reducing emissions from our own professional activities, which has health cobenefits for the entire population.
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Affiliation(s)
- Leticia Nogueira
- Surveillance and Health Equity Sciences, American Cancer Society, Palm Harbor, FL, USA.
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3
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Ginex P, Dickman E, Elia MR, Burbage D, Wilson R, Koos JA, Sivakumaran K, Morgan RL. Climate disasters and oncology care: a systematic review of effects on patients, healthcare professionals, and health systems. Support Care Cancer 2023; 31:403. [PMID: 37338628 DOI: 10.1007/s00520-023-07842-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE Climate disasters have devastating effects on communities and society that encompass all aspects of daily life, including healthcare. Patients with cancer are particularly vulnerable when disaster strikes. As the number and intensity of disasters increases, it is important to understand the effects across the cancer care continuum. This systematic review investigates the effect of climate disasters on patients, the oncology healthcare workforce, and healthcare systems. METHODS A medical librarian conducted a literature search in PubMed, Embase, CINAHL, and Web of Science from January 1, 2016, through May 11, 2022. Eligible studies included any published report on a climate disaster globally reporting on patient-, oncology healthcare workforce-, or healthcare systems-level outcomes. Study quality was assessed, and findings were narratively synthesized, given the diversity of reported evidence. RESULTS The literature search identified 3618 records, of which 46 publications were eligible for inclusion. The most frequent climate disaster was hurricanes (N = 27) followed by tsunami (N = 10). Eighteen publications were from disasters that occurred in the mainland USA with 13 from Japan and 12 from Puerto Rico. Patient-level outcomes included treatment interruptions and inability to communicate with the healthcare team. At the workforce level, findings included distressed clinicians caring for others when their own lives have been affected by a disaster along with lack of disaster preparedness training. Health systems reported closures or shifting services post-disaster and a need to have improved emergency response plans. CONCLUSION Response to climate disasters necessitates a holistic approach at the patient, workforce, and health systems levels. Specifically, interventions should focus on mitigating interruptions in care for patients, advanced coordination and planning for workforce and health systems, and contingency planning for allocation of resources by health systems.
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Affiliation(s)
- Pamela Ginex
- Stony Brook University School of Nursing, Stony Brook, NY, USA.
| | - Erin Dickman
- Oncology Clinical Specialist, Oncology Nursing Society, Pittsburgh, PA, USA
| | | | | | - Ryne Wilson
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Jessica A Koos
- Stony Brook University Health Sciences Library, Stony Brook, NY, USA
| | | | - Rebecca L Morgan
- Evidence Foundation, Cleveland Heights, OH, USA
- McMaster University, Hamilton, ON, Canada
- Case Western Reserve University, Cleveland, OH, USA
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4
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Colón-López V, Sánchez-Cabrera Y, Soto-Salgado M, Ortiz-Ortiz KJ, Quast T, Fernández ME. 'More stressful than cancer': Treatment Experiences Lived During Hurricane Maria among Breast and Colorectal Cancer Patients in Puerto Rico. Res Sq 2023:rs.3.rs-2689228. [PMID: 37066399 PMCID: PMC10104257 DOI: 10.21203/rs.3.rs-2689228/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Background This study explored experiences in cancer care and disruption after Hurricanes Irma and Maria's aftermath in Puerto Rico (PR). Methods A total of three focus groups were conducted among breast and colorectal cancer patients diagnosed six months before the disaster. Results The most prevalent themes were (a) barriers related to their cancer treatment, (b) facilitators related to their cancer treatment, and (c) treatment experiences during the hurricane. Participants discussed struggles regarding their experience with treatment and access to care during and after Hurricanes Irma and Maria and how household limitations due to lack of electricity and water deter their intention to continue their treatment. Moreover, stressors directly linked with the disaster were the most challenging to cope with. Conclusions Our study identifies the hardships experienced by cancer patients living during a disaster. Similarly, our study highlights the impending need to address in future emergency plans the individual and system needs of cancer patients in active treatment to minimize the delay in continuing cancer care.
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Affiliation(s)
- Vivian Colón-López
- Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, San Juan
| | - Yara Sánchez-Cabrera
- University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research, San Juan
| | - Marievelisse Soto-Salgado
- Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, San Juan
| | - Karen J Ortiz-Ortiz
- Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, San Juan
| | - Troy Quast
- University of South Florida, College of Public Health, Tampa, FL
| | - María E Fernández
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston, TX
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5
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Johnson M, Parada H, Ferran K, Perez R, Calo W, Sant'Ana IDL, Ocasio LM, Mendez-Lazaro PA, Garcia SI, Tortolero-Luna G, Umpierre SA, Ortiz AP. Perceptions of preparedness, timing of cancer diagnosis, and objective emergency preparedness among gynecological cancer patients in Puerto Rico before and after Hurricane Maria. J Cancer Policy 2023; 36:100415. [PMID: 36828176 DOI: 10.1016/j.jcpo.2023.100415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES This study investigated the impact of cancer diagnosis status, individual feelings of preparedness, and other covariates on objective emergency preparedness among women diagnosed with gynecological cancers before or after the 2017 Hurricanes Irma and Maria in Puerto Rico. METHODS This study included 240 women who were interviewed by telephone from 9/2019-11/2020. Objective emergency preparedness was assessed using a list of six items. Subjective emergency preparedness was assessed by asking the women how prepared they felt (well, somewhat, or not at all) to face an emergency. Crude and multivariable logistic regression analyses were conducted to assess the associations (odds ratios [ORs] and 95% confidence intervals [CIs]) between variables of interest and objective preparedness. RESULTS Before and after the hurricanes, 60% and 66% of women, respectively, were objectively prepared. Before the hurricanes, women reporting feeling well-prepared (vs. not prepared) (OR=9.31, 95%CI:3.96-21.91) and those who were diagnosed before (vs. after) the hurricanes (OR=1.71, 95%CI:0.95-3.09) were more likely to be objectively prepared. After the hurricanes, self-perceived well-preparedness (OR=2.46, 95% CI: 1.10-5.51) was positively associated with emergency preparedness when compared to feeling unprepared. CONCLUSIONS Perceptions of emergency preparedness and having a cancer diagnosis increased the likelihood of being objectively prepared for an emergency. POLICY SUMMARY This study demonstrates the need for state, territorial, and federal governments to include emergency preparedness plans for cancer patients in the Comprehensive Cancer Control plans. The study also indicates a need for cancer specific emergency preparedness information to be readily available for patients.
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Affiliation(s)
- Meghan Johnson
- Division of Epidemiology & Biostatistics, School of Public Health, San Diego State University, USA.
| | - Humberto Parada
- Division of Epidemiology & Biostatistics, School of Public Health, San Diego State University, USA; UC San Diego Health Moores Cancer Center, La Jolla, CA, USA
| | - Karen Ferran
- Division of Epidemiology & Biostatistics, School of Public Health, San Diego State University, USA
| | - Ramona Perez
- Center for Latin American Studies, San Diego State University, San Diego, CA, USA
| | - William Calo
- Penn State College of Medicine, Hershey, PA, USA
| | - Istoni da Luz Sant'Ana
- Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Liz Martínez Ocasio
- Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Pablo A Mendez-Lazaro
- Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Sandra I Garcia
- Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Guillermo Tortolero-Luna
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Sharee A Umpierre
- Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico; Department of OBGYN, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Ana Patricia Ortiz
- Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico; Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
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Lichter KE, Baniel CC, Anderson J, Bhatia R, Frick MA, Thiel CL, Gandhi S, Sarria GR, Bagshaw HP, Petereit D, Chino J, Grover S, Singer L, Hsu IC, Mohamad O. Environmentally sustainable brachytherapy care. Brachytherapy 2022; 21:712-717. [PMID: 35794032 PMCID: PMC9997716 DOI: 10.1016/j.brachy.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/20/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Katie E Lichter
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA.
| | - Claire C Baniel
- Department of Radiation Oncology, Stanford University, Palo Alto, CA
| | | | - Rohini Bhatia
- Department of Radiation Oncology and 334 Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD
| | - Melissa A Frick
- Department of Radiation Oncology, Stanford University, Palo Alto, CA
| | - Cassandra L Thiel
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY
| | - Seema Gandhi
- Department of Anesthesia, University of California San Francisco, San Francisco, CA
| | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Hilary P Bagshaw
- Department of Radiation Oncology, Stanford University, Palo Alto, CA
| | | | - Junzo Chino
- Department of Radiation Oncology, Duke Cancer Center, Durham, NC
| | - Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Botswana-UPenn Partnership, Philadelphia, PA
| | - Lisa Singer
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
| | - I-Chow Hsu
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
| | - Osama Mohamad
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA; Department of Urology, University of California San Francisco, San Francisco, CA
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Lichter KE, Anderson J, Sim AJ, Baniel CC, Thiel CL, Chuter R, Collins A, Carollo E, Berg CD, Coleman CN, Abdel-Wahab M, Grover S, Singer L, Mohamad O. Transitioning to Environmentally Sustainable, Climate-Smart Radiation Oncology Care. Int J Radiat Oncol Biol Phys 2022; 113:915-924. [PMID: 35841919 PMCID: PMC10024638 DOI: 10.1016/j.ijrobp.2022.04.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/28/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Katie E Lichter
- Department of Radiation Oncology, University of California, San Francisco, California.
| | - Justin Anderson
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona
| | - Austin J Sim
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida; Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Claire C Baniel
- Department of Radiation Oncology, Stanford University, Palo Alto, California
| | - Cassandra L Thiel
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Robert Chuter
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Heath, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Amy Collins
- Health Care Without Harm, Reston, Virginia; Department of Emergency Medicine, MetroWest Medical Center, Framingham, Massachusetts
| | - Erin Carollo
- Loyola University Chicago-Stritch School of Medicine, Chicago, Illinois
| | | | - C Norman Coleman
- Radiation Research Program, National Cancer Institute, Bethesda, Maryland
| | - May Abdel-Wahab
- Division of Human Health, Radiation Oncology, International Atomic Energy Agency, Vienna, Austria
| | - Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Botswana-UPenn Partnership, Philadelphia, Pennsylvania
| | - Lisa Singer
- Department of Radiation Oncology, University of California, San Francisco, California
| | - Osama Mohamad
- Department of Radiation Oncology, University of California, San Francisco, California; Department of Urology, University of California, San Francisco, California
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8
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Calo WA, Rivera M, Mendez-Lazaro PA, Garcia-Camacho SI, Bernhardt Utz YM, Acosta-Perez E, Ortiz AP. Disruptions in Oncology Care Confronted by Patients with Gynecologic Cancer Following Hurricanes Irma and Maria in Puerto Rico. Cancer Control 2022; 29:10732748221114691. [PMID: 35833604 PMCID: PMC9290156 DOI: 10.1177/10732748221114691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/10/2022] [Accepted: 07/01/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In September 2017, hurricanes Irma and Maria affected Puerto Rico (PR) and the US Virgin Islands (USVI), causing major disruptions in basic services and health care. This study documented the stressors and experiences of patients with gynecologic cancer receiving oncology care in PR following these hurricanes. METHODS We conducted 4 focus groups (December 2018-April 2019) among women aged ≥21 years from PR who were diagnosed with gynecological cancer between September 2016 and September 2018 (n = 24). Using the same eligibility criteria, we also interviewed patients from the USVI (n = 2) who were treated in PR. We also conducted key-informant interviews with oncology care providers and administrators (n = 23) serving gynecologic cancer patients in PR. Discussions were audio-recorded, transcribed verbatim, and coded to identify emergent themes using a constant comparison method. RESULTS Analyses of focus group discussions and interviews allowed us to identify the following emergent themes: 1) disruptions in oncology care were common; 2) communication between oncology providers and patients was challenging before and after the hurricanes hit; 3) patient resilience was key to resume care; and 4) local communities provided much-needed social support and resources. CONCLUSIONS This study provides firsthand information about the disruptions in oncology care experienced by and the resiliency of women with gynecologic cancer following hurricanes Irma and Maria. Our findings underscore the need to incorporate oncology care in the preparedness and response plans of communities, health systems, and government agencies to maintain adequate care for cancer patients during and after disasters such as hurricanes.
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Affiliation(s)
- William A. Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Penn State Cancer Institute, Hershey, PA, USA
| | - Mirza Rivera
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
| | - Pablo A. Mendez-Lazaro
- Department of Environmental Health, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
| | - Sandra I. Garcia-Camacho
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR, USA
| | - Yanina M. Bernhardt Utz
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR, USA
| | - Edna Acosta-Perez
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
- Hispanic Alliance of Clinical and Translational Research, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
| | - Ana P. Ortiz
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
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Miller KD, Ortiz AP, Pinheiro PS, Bandi P, Minihan A, Fuchs HE, Martinez Tyson D, Tortolero-Luna G, Fedewa SA, Jemal AM, Siegel RL. Cancer statistics for the US Hispanic/Latino population, 2021. CA Cancer J Clin 2021; 71:466-487. [PMID: 34545941 DOI: 10.3322/caac.21695] [Citation(s) in RCA: 143] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 01/03/2023] Open
Abstract
The Hispanic/Latino population is the second largest racial/ethnic group in the continental United States and Hawaii, accounting for 18% (60.6 million) of the total population. An additional 3 million Hispanic Americans live in Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanic individuals in the United States using the most recent population-based data. An estimated 176,600 new cancer cases and 46,500 cancer deaths will occur among Hispanic individuals in the continental United States and Hawaii in 2021. Compared to non-Hispanic Whites (NHWs), Hispanic men and women had 25%-30% lower incidence (2014-2018) and mortality (2015-2019) rates for all cancers combined and lower rates for the most common cancers, although this gap is diminishing. For example, the colorectal cancer (CRC) incidence rate ratio for Hispanic compared with NHW individuals narrowed from 0.75 (95% CI, 0.73-0.78) in 1995 to 0.91 (95% CI, 0.89-0.93) in 2018, reflecting delayed declines in CRC rates among Hispanic individuals in part because of slower uptake of screening. In contrast, Hispanic individuals have higher rates of infection-related cancers, including approximately two-fold higher incidence of liver and stomach cancer. Cervical cancer incidence is 32% higher among Hispanic women in the continental US and Hawaii and 78% higher among women in Puerto Rico compared to NHW women, yet is largely preventable through screening. Less access to care may be similarly reflected in the low prevalence of localized-stage breast cancer among Hispanic women, 59% versus 67% among NHW women. Evidence-based strategies for decreasing the cancer burden among the Hispanic population include the use of culturally appropriate lay health advisors and patient navigators and targeted, community-based intervention programs to facilitate access to screening and promote healthy behaviors. In addition, the impact of the COVID-19 pandemic on cancer trends and disparities in the Hispanic population should be closely monitored.
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Affiliation(s)
- Kimberly D Miller
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Ana P Ortiz
- Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Paulo S Pinheiro
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida
| | - Priti Bandi
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Adair Minihan
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Hannah E Fuchs
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | | | - Guillermo Tortolero-Luna
- Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Stacey A Fedewa
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Ahmedin M Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Rebecca L Siegel
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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10
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Méndez-Lázaro PA, Bernhardt YM, Calo WA, Pacheco Díaz AM, García-Camacho SI, Rivera-Lugo M, Acosta-Pérez E, Pérez N, Ortiz-Martínez AP. Environmental Stressors Suffered by Women with Gynecological Cancers in the Aftermath of Hurricanes Irma and María in Puerto Rico. Int J Environ Res Public Health 2021; 18:11183. [PMID: 34769708 DOI: 10.3390/ijerph182111183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 12/23/2022]
Abstract
Background: Hurricanes are the immediate ways that people experience climate impacts in the Caribbean. These events affect socio-ecological systems and lead to major disruptions in the healthcare system, having effects on health outcomes. In September 2017, Puerto Rico (PR) and the United States Virgin Islands (USVI) experienced one of the most catastrophic hurricane seasons in recent history (Hurricane Irma was a Category 5 and Hurricane María was a Category 4 when they hit PR). Objective: This study examines environmental stressors experienced by women with gynecologic (GYN) cancers from PR and USVI who received oncologic cancer care in PR, in the aftermath of the hurricanes. Methods: A descriptive qualitative study design was used to obtain rich information for understanding the context, barriers, knowledge, perspectives, risks, vulnerabilities, and attitudes associated to these hurricanes. We performed focus groups among GYN cancer patients (n = 24) and key-informant interviews (n = 21) among health-care providers and administrators. Interviews were conducted from December 2018–April 2019. Results: Environmental health stressors such as lack of water, heat and uncomfortable temperatures, air pollution (air quality), noise pollution, mosquitos, and rats ranked in the top concerns among cancer patients and key-informants. Conclusions: These findings are relevant to cancer patients, decision-makers, and health providers facing extreme events and disasters in the Caribbean. Identifying environmental secondary stressors and the most relevant cascading effects is useful for decision-makers so that they may address and mitigate the effects of hurricanes on public health and cancer care.
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11
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Ortiz AP, Gierbolini-Bermúdez A, Ramos-Cartagena JM, Colón-López V, Sonawane K, Deshmukh AA, Ortiz-Ortiz KJ. Cervical Cancer Screening Among Medicaid Patients During Natural Disasters and the COVID-19 Pandemic in Puerto Rico, 2016 to 2020. JAMA Netw Open 2021; 4:e2128806. [PMID: 34652451 PMCID: PMC8520125 DOI: 10.1001/jamanetworkopen.2021.28806] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This cohort study examines rates of cervical cancer screening in Puerto Rico among women with Medicaid health coverage following the 2017 hurricanes, earthquakes in late 2019-2020, and the 2020 COVID-19 lockdown.
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Affiliation(s)
- Ana Patricia Ortiz
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Axel Gierbolini-Bermúdez
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Jeslie M. Ramos-Cartagena
- Department of University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research Program, San Juan, Puerto Rico
| | - Vivian Colón-López
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Kalyani Sonawane
- Center for Health Services Research, Department of Management, Policy, and Community Health, University of Texas Health School of Public Health, Houston
| | - Ashish A. Deshmukh
- Center for Health Services Research, Department of Management, Policy, and Community Health, University of Texas Health School of Public Health, Houston
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