Limited Health Care Access During Disasters Delays Colorectal Cancer Diagnoses

Natural disasters like Hurricanes Irma and Maria, along with the COVID-19 pandemic, significantly disrupted access to colorectal cancer (CRC) screening and diagnosis in Puerto Rico. A new study published in CANCER, a peer-reviewed journal of the American Cancer Society, highlights how these events contributed to a sharp drop in CRC diagnoses — followed by an eventual spike in late-stage cases.

Impact of Limited Health Care Access on Colorectal Cancer Diagnoses

The research, conducted using data from the Puerto Rico Central Cancer Registry (2012–2021), shows that healthcare infrastructure damage, staff shortages, and reduced patient access during disasters caused major interruptions in colorectal cancer diagnoses.

In the month Hurricanes Irma and Maria struck, only 82 CRC cases were diagnosed, compared to the expected 161.4 cases. A similar pattern was seen during the COVID-19 lockdown in April 2020, with only 50 diagnosed cases, far below the expected 162.5.

These findings further underscore why cancer survivors urgently need funded rehabilitation care, especially in regions vulnerable to natural disasters or systemic health disruptions. Strengthening long-term survivorship services is essential for recovery and quality of life.

Late-Stage Colorectal Cancer Cases on the Rise

By the end of the study, early-stage CRC diagnoses and cases among adults aged 50–75 (the recommended screening group) remained below expected levels. However, late-stage CRC diagnoses and cases in adults <50 and ≥76 years rose above projections.

These trends suggest that limited access to timely cancer screening during disasters led to delayed detection, increasing the risk of worse health outcomes and reduced survival rates.

Experts Urge Strengthening Health Systems for Future Resilience

“These findings emphasize the critical importance of maintaining access to essential health services even during crises,” said Tonatiuh Suárez-Ramos, MS, co–lead author of the study.

Co-lead author Yisel Pagán-Santana, DrPH, added, “Understanding these disruptions is key to developing resilient and adaptable strategies for future disasters.”

Dr. Karen J. Ortiz-Ortiz, DrPH, the study’s senior author, called for urgent policy actions: “Strengthening cancer care infrastructure and coordination in disaster-prone areas like Puerto Rico is essential to minimize health disparities and ensure continuity of care during emergencies.”

For more information: Suárez-Ramos, T., et al. (2025) Evaluating the impact of hurricanes and the COVID-19 pandemic on colorectal cancer incidence in Puerto Rico: An interrupted time-series analysis. Cancer. doi.org/10.1002/cncr.35793.