Cases of colon cancer have increased by 20% since 1995, particularly in younger adults. The starting point for regular screenings has been dropped to age 45 from age 50 because of this trend. Experts suggest that the cause of the change is mostly lifestyle factors. Americans now eat more processed foods and lead more sedentary lives than in the past. This is true in Puerto Rico as well as in the nation at large; in fact, rates of colon cancer are almost twice as high among Puerto Rico’s young adults than in the U.S. as a whole.
On the other hand, older Americans are less likely to show late-stage cancer because of improvements in identifying the disease early and treating it.
An exception
Puerto Rico showed a different pattern after Hurricane Maria in 2017. In fact, new cases of colon cancer fell by 17.5%. A further drop took place when the COVID-19 pandemic hit the Island, resulting in a decrease of 24.2%.
Was this a silver lining to the disasters’ clouds? Were people healthier in these challenging circumstances, perhaps because they were more active or had less access to processed foods?
Recent research suggests that there is a different reason entirely for the decrease in new cases of colon cancer during these difficult times. People did not have access to healthcare and so did not receive screenings. The result was an increase in cases among older adults, especially in late-stage cases. These people did not have the opportunity to find their cancers early, when it is easier to treat. Recovery from cancer is much more likely when it is found early.
Was it different for states?
While there has been some speculation that cancer rates might have risen in Texas following 2017’s Hurricane Harvey, perhaps because of increased environmental toxins, these possible changes were found only in specific areas. They also were not as clear as the changes in Puerto Rico. Instead, Puerto Rico followed the global pattern that shows older adults in particular being more likely to develop cancer after disasters. This tends not to be true in the United States, where natural disasters rarely disrupt lives enough to prevent adequate health care.
A counterexample for the states is the COVID-19 pandemic, which disrupted health care significantly. Many hospitals and other healthcare facilities were so overwhelmed by COVID cases that they stopped doing routine screenings for cancer. Sometimes people hesitated to take the risk of going to healthcare facilities for fear of meeting contagious people there. And of course people experiencing COVID did not prioritize routine screenings. Many people missed vaccinations, mammograms, and other preventive care, as well as colonoscopies.
Why did Hurricane Maria have this effect in Puerto Rico when the pattern wasn’t seen in states experiencing natural disasters?
Puerto Rico received less support
Studies showed that disaster response in Puerto Rico was “slower and less generous” than responses in Florida and Texas. Residents of the Island faced not only the immediate danger of the hurricanes, but also the long-term dangers of being without electricity and drinkable water. In all, some 3,000-4,000 people died from Hurricane Maria.
Healthcare is also more difficult to access in Puerto Rico at the best of times, for several reasons:
- inequity in federal funding compared with the states
- shortages of medical professionals
- infrastructure problems making it hard for doctors to do their jobs
These issues exacerbated the problems following Hurricane Maria.
What can we learn from this?
Colon cancer may not be top of mind for many of our readers. To us, it’s another example of how Puerto Rico’s colonial status creates hardship for the three million plus U.S. citizens living on the Island. Let your congressional representatives know that you support statehood for Puerto Rico, and let’s end the colonial relationship.
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