Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation on the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer survivors, were significantly affected. The goal of this study was to assess the impact of HM on barriers to care, emotional distress, and inflammatory biomarkers among cancer survivors in PR. This exploratory longitudinal study was conducted in health care facilities and community support groups from PR. Cancer survivors (n = 50) and non-cancer participants (n = 50) completed psychosocial questionnaires and provided blood samples that were used to assess inflammatory cytokines levels. Among this cohort, we identified 41 matched cancer survivors/noncancer participants pairs. Data were analyzed through descriptive, frequencies, correlational, and regression analyses. Cancer survivors that were affected by HM reported increased barriers in accessing medical care, which were directly associated with anxiety, perceived stress, and post-traumatic symptomatology. Moreover, being a cancer survivor, predicted more barriers to receiving health care, especially in the first six weeks after the event, after which the effect was attenuated. Several inflammatory cytokines, such as CD31, BDNF, TFF3, Serpin E-1, VCAM-1, Vitamin D BP, and PDGF-AA, were significantly upregulated in cancer survivors while MMP9 and Osteopontin both had significant positive correlations with barriers to care. HM significantly impacted Puerto Ricans psychosocial wellbeing. Cancer survivors had significant barriers to care and showed increased serum inflammatory cytokines but did not show differences in anxiety, stress, and post-traumatic symptoms compared to non-cancer participants. Natural disasters can significantly alter an individual's daily life and lead to psychological distress, particularly in medically fragile populations such as cancer survivors. Hurricane Maria (HM) made landfall in Puerto Rico (PR) on September 20, 2017, as Category 4 storm, killing an estimated 2,975 people and causing an estimated $90 billion in damages 1-3. Widespread devastation included loss of power and potable water infrastructure; destruction of buildings, bridges, and roads; lack of telecommunications; and closing of ports and airports 4. Lack of access to food and clean water was a significant problem for residents of PR 4. Mudslides rendered many roads in rural

Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation in the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer survivors, were significantly affected. The goal of this study was to assess the impact of HM on barriers to care, emotional distress, and inflammatory biomarkers among cancer survivors in PR. This exploratory longitudinal study was conducted in health care facilities and community support groups from PR. Cancer survivors (n=50) and non-cancer participants (n=50) completed psychosocial questionnaires and provided blood samples that were used to assess inflammatory cytokines levels. Data were analyzed through descriptive, frequencies, correlational, and linear regression analyses. Cancer survivors that were affected by HM reported increased barriers in accessing medical care, which were directly associated with anxiety, perceived stress, and post-traumatic symptomatology. Moreover, being a cancer survivor, along with closeness in time from HM predicted more barriers to receiving health care. Several inflammatory cytokines, such as CD31, BDNF, TFF3, Serpin E-1, Vitamin D BP, VCAM-1, Osteopontin, Chitinase 3 like 1, MMP-9 and MIF were significantly upregulated in cancer survivors while BDNF, MMP9 and Osteopontin had significant positive correlations with barriers to care. HM significantly impacted Puerto Ricans psychosocial well-being. Cancer survivors had significant barriers to care and showed increased serum inflammatory cytokines, but did not show differences in anxiety, stress and post-traumatic symptoms compared to non-cancer participants

Background: Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation in the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer patients and survivors, were significantly affected. The goal of the current study was to assess the impact of HM on barriers to care, emotional distress and inflammatory biomarkers among cancer patients in PR. Methods: This exploratory longitudinal study was conducted in health care facilities and community support groups from PR. Cancer patients (n=50) and non-cancer patients (n=50) completed a battery of psychosocial questionnaires and provided blood samples that were utilized to assess inflammatory cytokines levels. Data were analyzed through descriptive, frequencies, correlational and linear regression analyses. Results: Cancer patients that were affected by HM reported increased barriers in accessing medical care, which were positively associated with anxiety, perceived stress, and post-traumatic symptomatology. Moreover, being a cancer patient or survivor, along with closeness in time from HM predicted more barriers to receiving health care. Several inflammatory cytokines were significantly upregulated in cancer patients and positively correlated with barriers to care. Conclusions: HM significantly impacted Puerto Ricans psychosocial well-being. Cancer patients had significant barriers to care and increased serum inflammatory cytokines, but similar anxiety, stress and post-traumatic symptoms compared to non-cancer controls. Impact: These findings demonstrate the urgency of delineating a plan for providing cancer care to patients in the aftermath of a natural disaster while promoting and influencing resilience and well-being. Citation Format: Mary Rodriguez-Rabassa, Ruthmarie Hernandez, Zindie Rodriguez, Claudia B Colon-Echevarria, Lizette Maldonado, Nelmit Tollinchi, Estefania Torres, Adnil Mulero, Daniela Albors, Jaileene Perez-Morales, Idhaliz Flores, Heather Jim, Eida M Castro, Guillermo N Armaiz-Pena. Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer patients [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A042.