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Lichter KE, Baniel CC, Do I, Medhat Y, Avula V, Nogueira LM, Bates JE, Paulsson A, Malik N, Hiatt RA, Yom SS, Mohamad O. Effects of Wildfire Events on California Radiation Oncology Clinics and Patients. Adv Radiat Oncol 2024; 9:101395. [PMID: 38304108 PMCID: PMC10831805 DOI: 10.1016/j.adro.2023.101395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 02/03/2024] Open
Abstract
Purpose The effect of climate-driven events, such as wildfires, on health care delivery and cancer care is a growing concern. Patients with cancer undergoing radiation therapy are particularly vulnerable to treatment interruptions, which have a direct effect on survival. We report the results of a study characterizing the effect of wildfires on radiation oncology clinics and their patients. Methods and Materials A survey of California radiation oncologists was used to evaluate emergency preparedness and the effect of wildfires on the delivery of radiation therapy services between 2017 and 2022. Descriptive statistics and Pearson's χ2 tests were performed to investigate potential relationships between provider characteristics, practice settings, and perceptions of the effect of wildfire events. California Department of Forestry and Fire Protection data were employed to map the geographic distribution of wildfires to clinic locations. Results Response rate was 12.3% (51/415 radiation oncologists), representing 25% of clinics (43/176) in 41% (24/58) of California counties. Sixty-one percent (31/51) of respondents reported being affected by a wildfire, 2 of which are rural clinics (100%, 2/2) and 29 are (59%, 29/49) metropolitan practices. Of these, 18% (9/51) reported a clinic closure, and 29% (15/51) reported staffing shortages. Respondents reported effects on patients, including having to evacuate (55%, 28/51), cancel/reschedule treatments (53%, 27/51), and experiencing physical, mental, or financial hardship due to wildfires (45%, 23/51). Respondents described effects on clinical operations, including being forced to transfer patients (24%, 12/51), transportation interruptions (37%, 19/51), regional/community evacuations (35%, 18/51), and physical/mental health effects (27%, 14/51) on clinic personnel. Less than half of the respondents (47%, 24/51) reported their workplace had a wildfire emergency preparedness plan. Additionally, geographic analysis revealed that 100% (176/176) of clinics were located within 25 miles of a wildfire. Conclusions This study highlights the effects of wildfires on radiation oncology clinics and patients and underscores the need for emergency preparedness planning to minimize the consequences of such disasters.
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Affiliation(s)
- Katie E. Lichter
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
- The Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Claire C. Baniel
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Isabelle Do
- University of California, Berkeley, Berkeley, California
| | - Yasmeen Medhat
- University of California, Berkeley, Berkeley, California
| | - Vennela Avula
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - James E. Bates
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | | | - Nauman Malik
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Robert A. Hiatt
- The Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Sue S. Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Osama Mohamad
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Gyawali B, Sharma S, Shilpakar R, Dulal S, Pariyar J, Booth CM, Sharma Poudyal B. Overview of Delivery of Cancer Care in Nepal: Current Status and Future Priorities. JCO Glob Oncol 2021; 6:1211-1217. [PMID: 32735488 PMCID: PMC7395484 DOI: 10.1200/go.20.00287] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nepal is a small, low-income country between India and China with a unique health care delivery system. Cancer is becoming an important public health problem in the country, but a systematic plan to cancer control is lacking. In this article, we aim to provide a systematic assessment of the burden of disease and available resources and suggest prioritization approaches for the future to assist with any such future cancer control plans for the country.
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Affiliation(s)
- Bishal Gyawali
- Department of Oncology, Department of Public Health Sciences and Division of Cancer Care and Epidemiology, Queen's University, Kingston, Ontario, Canada
| | - Shubham Sharma
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Ramila Shilpakar
- Department of Clinical Oncology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Soniya Dulal
- Department of Clinical Oncology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Jitendra Pariyar
- Gynecologic Oncology Unit, Civil Service Hospital, Minbhawan, Kathmandu, Nepal
| | - Christopher M Booth
- Department of Oncology, Department of Public Health Sciences and Division of Cancer Care and Epidemiology, Queen's University, Kingston, Ontario, Canada
| | - Bishesh Sharma Poudyal
- Department of Clinical Oncology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.,Clinical Haematology and Bone Marrow Transplant Unit, Department of Medicine, Civil Service Hospital, Minbhawan, Kathmandu, Nepal
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Shrestha AD, Vedsted P, Kallestrup P, Neupane D. Prevalence and incidence of oral cancer in low- and middle-income countries: A scoping review. Eur J Cancer Care (Engl) 2019; 29:e13207. [PMID: 31820851 DOI: 10.1111/ecc.13207] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 11/14/2019] [Accepted: 11/23/2019] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Oral cancer is common cancer in many low- and middle-income countries (LMICs) with a low five-year survival rate. It is among the four most common types of cancer in South East Asia region. In South-Central Asia, lip and oral cavity cancer is the second most common cancer according to the specific cancer types. METHODS This scoping review intended to investigate published studies on the current prevalence and incidence of oral cancer in LMICs. The review was conducted applying the search words "Oral Cancer" and "Mouth neoplasm" as the Medical Subject Heading (MeSH) major topic and "Epidemiology" and ("prevalence" OR "incidence") as the MeSH subheading; the search was supplemented by cross-references. Included studies met the following criteria: original studies, reporting of prevalence or incidence rates, population-based studies, studies in English language and studies involving humans. RESULTS The sample sizes ranged from 486 to 101,761 with 213,572 persons included. Buccal mucosa is one of the most common sites of oral cancer, associated with the widespread exposure to chewing tobacco. The incidence is likely to rise in the region where gutkha, pan masala, pan-tobacco and various other forms of chewing tobacco are popular. CONCLUSION This review contributes to useful information on prevalence and incidence estimates of oral cancer in LMICs.
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Affiliation(s)
- Aamod D Shrestha
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus C, Denmark.,COBIN, Nepal Development Society, Bharatpur, Nepal
| | - Peter Vedsted
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Dinesh Neupane
- COBIN, Nepal Development Society, Bharatpur, Nepal.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Breast Cancer Provider Interval Length in Fukushima, Japan, After the 2011 Triple Disaster: A Long-Term Retrospective Study. Clin Breast Cancer 2019; 20:e127-e150. [PMID: 31980405 DOI: 10.1016/j.clbc.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/29/2019] [Accepted: 07/07/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Minimizing the interval from symptom onset to treatment commencement is essential for a favorable outcome among breast cancer (BC) patients. This study examined whether provider interval (time elapsed from first consultation to treatment initiation) lengthened among BC patients after Japan's 2011 earthquake, tsunami, and nuclear disaster in Fukushima. Factors associated with the length of postdisaster interval and whether the interval was associated with BC stage were also investigated. PATIENTS AND METHODS So-so District (study site) was an area damaged by the 2011 disasters. Data of all BC patients who made their first medical consultation and received initial treatment at the core medical institutions in the area 5 years before or after the disaster were extracted from patient medical records. We used several regression approaches to fulfill our study objectives. RESULTS We included 263 (140 predisaster and 123 postdisaster) patients. After adjustment for covariates, the interval did not significantly change after the disaster compared to before the disaster. Those with 4 or 5 cohabiting family members experienced a shorter interval after the disaster than those with 0 or 1 cohabiting family members (relative length, 0.47; 95% confidence interval, 0.28-0.78). Those with an interval of > 60 days had lower odds of stage III or IV cancer after the disaster than those with an interval of < 30 days (odds ratio, 0.09; 95% confidence interval, 0.01-0.84). CONCLUSION Overall, provider interval did not lengthen after the disaster. However, those with fewer cohabiting family members might have experienced a longer total interval. Cancer stage may not necessarily reflect the influence of interval on patient outcome.
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Uprety A, Ozaki A, Higuchi A, Ghimire B, Sawano T, Tsuda K, Nomura S, Leppold C, Tsubokura M, Tanimoto T, Singh YP. Long-term trends of hospital admissions among patients with cancer following the 2015 earthquake: a single institution observational study in Kathmandu, Nepal. BMJ Open 2019; 9:e026746. [PMID: 31256023 PMCID: PMC6609058 DOI: 10.1136/bmjopen-2018-026746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Little is known regarding how natural disasters affect patients with cancer in low-income and middle-income countries. The objective of the present study was to assess the impact of the 2015 Nepal earthquake on the admission of patients with cancer at a core medical institution in Kathmandu. DESIGN, SETTING AND PARTICIPANTS We considered all 3520 cancer patient admissions to Tribhuvan University Teaching Hospital, from 25 April 2013 to 24 April 2017 (2 years before and 2 years after the earthquake). OUTCOME MEASURES The number of cancer patient admissions was calculated for each month. Using a negative binomial model, we estimated the incidence rate ratio (IRR) for admission numbers each month after the earthquake compared with the pre-earthquake baseline and investigated chronological change. RESULTS The total admission number in the first month after the earthquake was decreased compared with that of the predisaster baseline (IRR=0.66, 95% CI 0.43 to 1.00), which largely reflected decreased admissions of patients from outside of the most disaster-affected districts. From the second month, the admission number consistently exceeded the predisaster baseline for the remaining postdisaster period. In contrast to the month of the disaster, the continuation of increased admissions was most prominent among those from outside of the most affected districts. CONCLUSIONS After a transient decrease immediately following the 2015 Nepal earthquake, there was a long-term increase in cancer patient admissions in a core hospital in Kathmandu. These changes were seen most prominently in patients from outside the most disaster affected areas.
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Affiliation(s)
- Anup Uprety
- Department of Anesthesiology, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Akihiko Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Asaka Higuchi
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Bikal Ghimire
- Department of Gastrointestinal and General Surgery, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Toyoaki Sawano
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Kenji Tsuda
- Department of Hematology and Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Shuhei Nomura
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Claire Leppold
- Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Masaharu Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Yogendra Prasad Singh
- Department of Gastrointestinal and General Surgery, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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Man RXG, Lack DA, Wyatt CE, Murray V. The effect of natural disasters on cancer care: a systematic review. Lancet Oncol 2019; 19:e482-e499. [PMID: 30191852 DOI: 10.1016/s1470-2045(18)30412-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 12/13/2022]
Abstract
As the incidence of cancer and the frequency of extreme weather events rise, disaster mitigation is becoming increasingly relevant to oncology care. In this systematic Review, we aimed to investigate the effect of natural disasters on cancer care and the associated health effects on patients with cancer. We searched MEDLINE, Embase, Scopus, CINAHL, PsycINFO, Web of Science, and ScienceDirect for articles published between database inception and November 12, 2016. Articles identifying the effect of natural disasters on oncology services or the associated health implications for patients with cancer were included. Only articles published in English were included. Data extraction was done by two authors independently and then verified by all authors. The effects of disaster events on oncology services, survival outcomes, and psychological issues were assessed. Of the 4593 studies identified, only 85 articles met all the eligibility criteria. Damage to infrastructure, communication systems and medication, and medical record losses substantially disrupt oncology care. The effect of extreme weather events on survival outcomes is limited to only a small number of studies, often with inadequate follow-up periods. Natural disasters cause substantial interruption to the provision of oncology care. To the best of our knowledge, this is the first systematic Review to assess the existing evidence base on the health effects of natural disaster events on cancer care. We advocate for the consideration of patients with cancer during disaster planning.
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Affiliation(s)
- Ralph Xiu-Gee Man
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
| | - David A Lack
- Emergency Department, Hervey Bay Hospital, Pialba, QLD, Australia
| | - Charlotte E Wyatt
- Dermatology Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Virginia Murray
- Global Disaster Risk Reduction, Public Health England, London, UK
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El Saghir NS, Soto Pérez de Celis E, Fares JE, Sullivan R. Cancer Care for Refugees and Displaced Populations: Middle East Conflicts and Global Natural Disasters. Am Soc Clin Oncol Educ Book 2018; 38:433-440. [PMID: 30231320 DOI: 10.1200/edbk_201365] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Conflicts and natural disasters can cause major disruptions to people's lives. Media and news agencies usually focus on immediate consequences of these events, including loss of life and injuries, environmental and property destruction, and relief efforts. In this article, we will examine the effects of conflicts (focusing on in the Middle East) and global natural disasters on patients already diagnosed with cancer and on those who are diagnosed with cancer during and in the immediate aftermath of these events. We will review the limited literature, provide situational analysis, and discuss medical relief efforts, governmental readiness, and the role of United Nations agencies and international nongovernmental organizations. We will also discuss treatment of patients with cancer in the context of prolonged displacements and limited resources.
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Affiliation(s)
- Nagi S El Saghir
- From the Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon; Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Institute of Cancer Policy and Centre for Study of Conflict & Health, King's College, London, United Kingdom
| | - Enrique Soto Pérez de Celis
- From the Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon; Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Institute of Cancer Policy and Centre for Study of Conflict & Health, King's College, London, United Kingdom
| | - Johny E Fares
- From the Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon; Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Institute of Cancer Policy and Centre for Study of Conflict & Health, King's College, London, United Kingdom
| | - Richard Sullivan
- From the Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon; Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Institute of Cancer Policy and Centre for Study of Conflict & Health, King's College, London, United Kingdom
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Caring for Cancer Patients After the Italian Earthquakes: A Proposal From the Field. Disaster Med Public Health Prep 2017; 11:4-6. [PMID: 28077193 DOI: 10.1017/dmp.2016.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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