Abstract LB-154: Disruption of essential services after Hurricanes Irma and Maria and quality of life among women with gynecological cancer receiving care in Puerto Rico
Authors: Ortiz Ana P. , García-Camacho Sandra , Pacheco-Díaz Andrea , Calo William , Umpierre Sharee A. , Méndez-Lazaro Pablo , DaLuz-Santana Istoni , Estremera-Rodriguez Lianeris , Rivera Mirza , Tortolero-Luna Guillermo 
Published: September 2020

Abstract
Objectives: Cancer patients have increased risk of poor outcomes after disasters. On September 2017 Hurricanes Irma and María affected Puerto Rico (PR), causing the population to experience major stressors. We describe the disruption of essential services among women with gynecologic cancer in PR after hurricanes Irma and Maria and its impact on quality of life (QoL). We also compare QoL of these women before and after the hurricanes. Methods: This ongoing cross-sectional study is recruiting women aged ≥21 years diagnosed between September 2016-September 2018 and receiving care in PR; we have conducted 110 phone interviews from September 2019-December 2019. Patients' interviews address stressors (including disruptions and time in essential services such as power, electricity and telecommunications) and multilevel responses experienced by the women in the aftermath of the hurricanes. QoL was measured by using a scale from the BRFSS, which includes six items within two domains: physical and mental health; these items were assessed at two time periods (30 days and 3 months) before and after the hurricanes. The association between disruption of essential services and QoL was evaluated with the Chi-square test. Paired McNemar's test was used to compare women's QoL before and after the hurricanes. Results: Mean age of study participants is 63.7±12.1 years; 64.5% of women had a diagnosis of endometrial cancer, 15.5% cervical, 15.5% ovarian, 3.6% vulvar, and 1.0% vaginal. 100% of patients reported disruptions in electric power, 84.5% in potable water, and 75.2% in telecommunications. On average, patients endured 114 days (±88.8) without electric power, 63 days (±62.8) without potable water, and 62 days (±56.3) without telecommunications. We did not find significant differences between the disruption of essential services and QoL indicators (p&gt;0.05). Nonetheless, QoL indicators were worst after the hurricanes than before. Frequent activity limitations (before=22.3% vs. after=39.1%), frequent mental distress (before=26.4% vs. after= 59.1%) and feeling dissatisfied/very dissatisfied with life (before=6.2% vs. after= 21.7%) increased (p&lt;0.001). Frequent physical distress (33.6% vs. 40.9%) and fair/poor general health status (33.9% vs. 50.9%) also increased after the hurricanes, these results were marginally significant (p&lt;0.10). Conclusion: Most of the patients experienced long interruptions in essential services, after hurricanes. The fact that all patients experienced some kind of disruption may explain the lack of association of these variables with QoL. Nonetheless, this study shows that participant's QoL worsened after the hurricanes. Study results should guide the development of a disaster management plan for cancer patients that focuses on minimizing the adverse effects on QoL in the aftermath of a catastrophic event. Acknowledgement: NCI Grant #R21CA239457
Citation Format: Ana P. Ortiz, Sandra García-Camacho, Andrea Pacheco-Díaz, William Calo, Sharee A. Umpierre, Pablo Méndez-Lazaro, Istoni DaLuz-Santana, Lianeris Estremera-Rodriguez, Mirza Rivera, Guillermo Tortolero-Luna. Disruption of essential services after Hurricanes Irma and Maria and quality of life among women with gynecological cancer receiving care in Puerto Rico [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr LB-154.