Abstract Introduction: Cancer care delivery is vulnerable to extreme weather events, particularly in low-resource settings where prolonged recovery periods can amplify health inequities. Patients undergoing oncologic treatment, including chemoradiation, often require uninterrupted, time-sensitive treatment, making them especially susceptible to climate-related care disruptions. Puerto Rico, a U.S. territory with high environmental and social vulnerability, experienced widespread infrastructure damage following Hurricane Maria in 2017.1,2 While initial health impacts have been documented, limited data exist on the long-term perspectives of oncology professionals regarding disaster preparedness, response, and patient impact. Methods: From October 2023 to January 2024, we surveyed radiation oncologists and medical physicists practicing in Puerto Rico to assess the effects of extreme weather events on patient care and clinic operations. Participants were identified through the American Society for Radiation Oncology directory and recruited with support from local collaborators. The survey instrument was adapted from a previously published survey tool evaluating wildfire-related disruptions to oncology care and was refined through a 10-person pilot to ensure contextual relevance.3 Descriptive and inferential statistical analyses were performed. Clinic locations were geocoded and assessed in relation to the U.S. Census Social Vulnerability Index (SVI). Results: We obtained responses from 10 participants (8 radiation oncologists, 2 medical physicists), representing 15 radiation therapy sites (response rate: 56%). Most sites (61.9%) were located in census tracts with ≥3 high SVI indicators. A majority (90%) of respondents reported that extreme weather events, including Hurricane Maria, had directly impacted cancer care delivery from 2017–2024. Respondents perceived that the greatest burdens fell on patients, citing barriers such as evacuations, food insecurity, and limited transportation (p0.005). Clinicians also reported personal impacts, including property damage and disruptions to childcare and schooling. Clinic operations were most affected by power outages and failures in communication infrastructure. 90% of respondents reported having implemented an emergency preparedness plan, most commonly including protocols for care transfers. Plans viewed as most effective involved coordination with health departments and community-based organizations. Eight respondents (80%) endorsed a stronger role for professional societies, particularly in providing patient education and financial support mechanisms. Conclusions: Radiation oncology providers in Puerto Rico report significant and ongoing disruptions in cancer care delivery from climate-related disasters. This underscores the urgent need for robust, equity-focused preparedness strategies. Future efforts should incorporate clinician insights, community vulnerability data, and collaboration with professional societies to strengthen disaster resilience across oncology care systems. 1PMID:37066399 2 30999000 3 3830410 Citation Format: Genevieve S. Silva, Leyda S. Marrero Morales, Isabelle Do, Taylor Drew, Ana Velazquez-Manana, Katie E. Lichter. ‘Natural’ disasters and cancer care disruptions: Perspectives from providers in Puerto Rico following hurricane Maria abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B110.
Silva et al. (Thu,) studied this question.
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