Investigators have proposed that cancer centers may be uniquely positioned to protect communities and patients with cancer from climate-driven disasters by bolstering climate change–associated emergency preparedness, according to a recent study published by Espinel et al in the Journal of the National Cancer Institute.
Background
All 71 of the National Cancer Institute (NCI)–designated cancer centers in the United States may have been impacted by one or more climate-related disasters—including wildfires, floods, hurricanes and tropical storms, severe ice and snowstorms, and extreme heat events—over the past decade. Cancer centers have gained experience in dealing with all types of climate hazards and already have emergency preparedness plans in place in accordance with the Centers for Medicare and Medicaid Services (CMS).
“During the COVID-19 pandemic, it became clear that cancer centers can adapt quickly to challenging circumstances and develop best practices to prioritize patient and public safety,” explained senior study author Leticia Nogueira, PhD, MPH, Scientific Director of Health Services Research and a senior principal scientist in the Department of Surveillance & Health Equity Science at the American Cancer Society (ACS). “[T]he same type of prioritization and collaboration between institutions and professionals from different backgrounds is urgently needed to better prepare and response to climate-driven disasters,” she urged.
However, although cancer centers have adapted quickly to the challenges posed by the COVID-19 pandemic, they may still face significant shortcomings in climate-related emergency preparedness—especially with regard to protecting the health and safety of patients with cancer.
Study Results Highlight Gaps in Emergency Preparedness
In this study, the investigators conducted an extensive audit of the cancer centers’ websites to identify and categorize their current emergency preparedness information, guidance, and practices. After completing their review, the investigators revealed significant information gaps and deficiencies. Here are some of them:
- Just 50% of the cancer centers posted emergency preparedness information specifically for patients with cancer.
- Less than 25% of cancer center websites contained emergency preparedness information for climate disasters, despite their increasing frequency and severity.
- Less than 10% of the cancer centers provided cancer-specific emergency preparedness materials related to climate-driven disasters.
- Just one cancer center’s website provided information on maintaining psychological health and well-being during climate disasters.
Although some of the websites outlined steps individuals can take to boost their personal emergency preparedness—including making disaster kits and evacuation plans as well as ensuring pet safety—only about 5% of them offered cancer-specific recommendations such as preregistering for special needs shelters, requesting additional medical supplies before the disasters, creating portable medical cards listing vital personal health information, and stocking medical items in disaster kits.
“As a psychiatrist, I know firsthand that the diagnosis and treatment of cancer bring about a multitude of stressors related to the physical, psychological, and socioeconomic consequences of the disease,” emphasized lead study author Zelde Espinel, MD, MA, MPH, Assistant Professor of Psychiatry and Behavioral Sciences at the Sylvester Comprehensive Cancer Center at the University of Miami. “Patients living with cancer—and their caregivers and care providers—have distinctive needs and vulnerabilities that are further amplified when faced with the risks posed by climate-driven extreme weather events,” she added.
Boosting Accessibility of Cancer-Specific Emergency Preparedness Information
“NCI-designated cancer centers are well positioned to advance knowledge and expertise about ‘climate-proofing’ health-care operations for patients [with cancer],” highlighted co–study author Tracy Crane, PhD, RDN, Associate Professor of Medicine in the Division of Medical Oncology at the Miller School of Medicine as well as Co-Leader of the Cancer Control Research Program and Director of Digital Health and Lifestyle Medicine for Cancer Survivorship at the Sylvester Comprehensive Cancer Center at the University of Miami. “They have greater access to resources through accreditation, established relationships with other health-care organizations, and are trusted entities within their communities,” she underscored.
The investigators noted that the cancer centers already have CMS-compliant emergency-preparedness plans that can be evaluated and revised to better protect medically vulnerable populations during climate disasters.
Further, the cancer centers can build on existing resources for centralized information sharing, such as the NCI’s Emergency Resources for the Cancer Community; the ACS’s Guide to Getting Ready for a Natural Disaster; and the Department of Health and Human Services’ website on hazard-specific content for actions before, during, and after disasters. Other federal and local resources are readily available and should be used as appropriate.
The investigators also recommended that the cancer centers observe structured information sharing to help them disseminate the lessons learned from previous climate disasters and coordinated research efforts to promote collaboration in evidence gathering, data analysis, implementation strategies, and communication methods that can lead to the development of best practices.
“Our research takes on even greater significance during the expansive heatwaves and climate disasters of 2023, as we encourage national cancer centers to pursue innovative strategies for enhancing emergency preparedness for their patients, providers, other staff, and care systems in this current era of compounding disasters,” suggested co–study author James M. Shultz, PhD, Associate Professor of Public Health Sciences in the Division of Epidemiology Population Health Sciences at the University of Miami Miller School of Medicine. Dr. Shultz’s current Protect and Promote Population Health in Complex Crises research program focuses on safeguarding medically high-risk patients—particularly patients with cancer—from the risks of disasters.
“Climate-related disasters are only expected to increase in the coming decade. Cancer centers have a responsibility and an opportunity to partner with their communities and ensure they are prepared to protect medically vulnerable populations, especially patients with cancer,” Dr. Crane concluded.
Disclosure: For full disclosures of the study authors, visit academic.oup.com.
