# Evaluating Potential Impacts of Climate‐Related Natural Disasters on Subsequent Prostate Cancer Mortality

## TL;DR

This study finds that climate-related natural disasters are linked to increased prostate cancer deaths in affected areas, possibly due to disrupted healthcare.

## Contribution

The study is the first to show a dose-dependent increase in prostate cancer mortality following climate-related natural disasters.

## Key findings

- Prostate cancer mortality increased by 15% one year after a disaster and 28% two years later.
- Mortality increased by 35% in counties with 'major' disasters.
- No such pattern was observed in counties without natural disasters.

## Abstract

Climate‐related disruptions to the health system may impact cancer outcomes. This may be particularly true for prostate cancer, which greatly contributes to cancer burden while existing on a risk spectrum, leading some men to delay treatment even in advanced cases.

The study included men diagnosed with metastatic prostate cancer from 2010 to 2020 within SEER‐supported counties that experienced a climate‐related natural disaster from 2012 to 2018. A smaller subgroup of “major” disasters was classified based on individual assistance from FEMA. Year of natural disaster was considered the index date, with 2‐year pre‐ and post‐disaster periods compared. Age‐standardized incidence‐based metastatic prostate cancer mortality (IBM) rates were extracted from SEER and adjusted for demographics. Counties were then compared 147 SEER counties without any climate‐related natural disaster.

There were 222 counties across 11 states experiencing a single disaster within the study period, covering an estimated 27,787,120 people. Compared to the index year, prostate cancer IBM was 15% higher (RR: 1.15, 95% CI 1.02–1.30) 1‐year post‐disaster and 28% higher (RR: 1.28, 95% CI 1.11–1.49) 2 years post‐disaster. Associations were stronger among counties (n = 50) experiencing a “major” disaster (RR: 1.21, 95% CI: 1.05–1.40) and 35% (RR: 1.35, 95% CI: 1.17–1.55) at 1 and 2 years. In non‐exposed counties, this pattern was absent.

We report a significant, dose‐dependent change in mortality from metastatic prostate cancer following a climate‐related natural disaster. The reasons are speculative but may include delayed diagnosis, care fragmentation, and interruptions for treatments for advanced disease including chemotherapy and radio‐hormonal therapy.

Counties included in SEER registry and with corresponding data on FEMA‐designated natural disasters.