{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:13:19Z","timestamp":1788286399090,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Major events, such as Hurricanes Irma and Maria and the coronavirus disease 2019 (COVID\u201019) pandemic disrupted Puerto Rico's health system. Lack of access to colorectal cancer (CRC) screening services may have impeded timely diagnosis. The authors examined the impact of these events on CRC incidence in Puerto Rico.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Puerto Rico Central Cancer Registry database allowed the authors to obtain CRC cases from 2012 to 2021. An interrupted time\u2010series analysis was performed to examine changes in CRC incidence immediately after and during the periods after the hurricanes and the pandemic. Analysis periods included: pre\u2010hurricanes, post\u2010hurricanes, and post\u2010COVID\u201019 lockdown restrictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed a level change of \u22128.3 CRC cases was observed in the month the hurricanes struck Puerto Rico, corresponding to an immediate decrease of 17.5%. After a slight upward trend, a second decline of 39.4 CRC cases was estimated after the COVID\u201019 lockdown restrictions, representing an immediate change of \u221224.2%. By the end of the study, the estimated numbers of patients with early stage CRC patients and those aged 50\u201375 years did not reach the expected numbers. In addition, CRC cases in patients with late\u2010stage disease and in those aged younger than 50 years and aged 76 years and older exceeded the expected numbers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hurricanes Irma and Maria and the COVID\u201019 pandemic caused a decrease in CRC incidence in Puerto Rico. This analysis suggests that limited access to CRC screening services during these events likely hindered CRC diagnoses. To fully understand the long\u2010term effects, monitoring of CRC trends will be necessary in the coming years.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35793","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T03:01:06Z","timestamp":1744599666000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluating the impact of hurricanes and the COVID\u201019 pandemic on colorectal cancer incidence in Puerto Rico: An interrupted time\u2010series analysis"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3596-4304","authenticated-orcid":false,"given":"Tonatiuh","family":"Su\u00e1rez\u2010Ramos","sequence":"first","affiliation":[{"name":"Puerto Rico Central Cancer Registry University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto 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Sciences University of Massachusetts Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3614-7034","authenticated-orcid":false,"given":"Carlos R.","family":"Torres\u2010Cintr\u00f3n","sequence":"additional","affiliation":[{"name":"Puerto Rico Central Cancer Registry University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9858-3441","authenticated-orcid":false,"given":"Eduardo J.","family":"Santiago\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Cancer Control and Population Sciences Program University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0134-9947","authenticated-orcid":false,"given":"Karen 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