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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.

Background: The incidence of sporadic colorectal cancer (CRC) among individuals <50 years (early-onset CRC) has been increasing in the United States (U.S.) and Puerto Rico. CRC is currently the leading cause of cancer death among Hispanic men and women living in Puerto Rico (PRH). The objective of this study was to characterize the molecular markers and clinicopathologic features of colorectal tumors from PRH to better understand the molecular pathways leading to CRC in this Hispanic subpopulation., Methods: Microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and KRAS and BRAF mutation status were analyzed. Sociodemographic and clinicopathological characteristics were evaluated using Chi-squared and Fisher's exact tests., Results: Of the 718 tumors analyzed, 34.2% ( n = 245) were early-onset CRC, and 51.7% were males. Among the tumors with molecular data available ( n = 192), 3.2% had MSI, 9.7% had BRAF , and 31.9% had KRAS mutations. The most common KRAS mutations observed were G12D (26.6%) and G13D (20.0%); G12C was present in 4.4% of tumors. A higher percentage of Amerindian admixture was significantly associated with early-onset CRC., Conclusions: The differences observed in the prevalence of the molecular markers among PRH tumors compared to other racial/ethnic groups suggest a distinct molecular carcinogenic pathway among Hispanics. Additional studies are warranted.