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Treatment Interruptions and Mortality Among Puerto Rican Women With Gynecologic Cancers in Puerto Rico After Hurricanes Irma and María: A Retrospective Cohort Study

Published online by Cambridge University Press:  21 May 2024

Fabiola A. Rivera-Gastón ,
Sharee Umpierre-Catinchi ,
Jeslie M. Ramos-Cartagena ,
Karen J. Ortiz-Ortiz ,
Carlos R. Torres-Cintrón ,
Sandra I. García-Camacho ,
William A. Calo ,
Guillermo Tortolero-Luna ,
Liz M. Martínez-Ocasio Open the ORCID record for Liz M. Martínez-Ocasio [Opens in a new window]  and
Ana P. Ortiz Open the ORCID record for Ana P. Ortiz [Opens in a new window]
Fabiola A. Rivera-Gastón
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
Sharee Umpierre-Catinchi
Affiliation:
University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
Jeslie M. Ramos-Cartagena
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
Karen J. Ortiz-Ortiz
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
Carlos R. Torres-Cintrón
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico Puerto Rico Central Cancer Registry, San Juan, Puerto Rico
Sandra I. García-Camacho
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
William A. Calo
Affiliation:
Penn State College of Medicine, Hershey, PA, USA Penn State Cancer Institute, Hershey, PA, USA
Guillermo Tortolero-Luna
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
Liz M. Martínez-Ocasio
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
Ana P. Ortiz*
Affiliation:
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
*
Corresponding author: Ana P. Ortiz; Email: [email protected].
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Abstract

Objective:

Cancer patients are among the most vulnerable populations during and after a disaster. We evaluated the impact of treatment interruption on the survival of women with gynecologic cancer in Puerto Rico following Hurricanes Irma and María.

Methods:

A retrospective cohort study among a clinic-based sample of women with gynecological cancer diagnosed between January 2016 and September 2017 (n = 112) was done. Women were followed from their diagnosis until December 2019, to assess vital status. Kaplan-Meier survival curves and Cox proportional hazards models were performed.

Results:

Mean age was 56 (± 12.3) years; corpus uteri (58.9%) was the most common gynecologic cancer. Predominant treatments were surgery (91.1%) and chemotherapy (44.6%). Overall, 75.9% were receiving treatment before the hurricanes, 16.1% experienced treatment interruptions, and 8.9% died during the follow-up period. Factors associated with treatment interruption in bivariate analysis included younger age (≤55 years), having regional/distant disease, and receiving > 1 cancer treatment (P < 0.05). Crude analysis revealed an increased risk of death among women with treatment interruption (HR: 3.88, 95% CI: 1.09-13.77), persisting after adjusting for age and cancer stage (HR: 2.49, 95% CI: 0.69-9.01).

Conclusions:

Findings underscore the detrimental impact of treatment interruption on cancer survival in the aftermath of hurricanes, emphasizing the need for emergency response plans for this vulnerable population.

Keywords

cancer survivaldisastersgynecologic cancerhurricanestreatment interruption
Type
Brief Report
Information
Disaster Medicine and Public Health Preparedness , Volume 18 , 2024 , e105
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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