Abstract A164: Social vulnerability index and climate extreme events impact on the excess mortality among Puerto Rican cancer patients

Abstract Purpose The impacts of climate-related events on cancer risk and treatment are becoming increasingly worrying among the Puerto Rican population. Over recent years, disruptions to medical care have made cancer treatment and access to essential health services a persistent challenge. Cancer patients are particularly vulnerable to climate hazards, which can interfere with treatment continuity and access to medications due to treatment disruption. Despite this, limited information exists on excess mortality or cancer survivability in Puerto Rico in the context of climate-related events. This study aims to address this gap by examining how the Social Vulnerability Index (SVI) and exposure to climate extremes contribute to cancer-related risk and disparities across Puerto Rican municipalities. Methods We analyzed age-adjusted cancer incidence rates by sex and county using data from the Puerto Rico Central Cancer Registry (PRCCR) from 2000 to 2019, grouped into four 5 year periods: 2000–2004, 2005–2009, 2010–2014, and 2015–2019. Temporal trends were assessed using linear regression for each county and sex, with age-adjusted rates as the outcome and time modeled as a continuous variable (coded 1 to 4). Only county–sex groups with complete data across all four periods were included in trend analyses to avoid bias. All statistical analyses were conducted using R version 4.4.1. A spatial correlation analysis was also performed to examine the overlap between cancer burden, social vulnerability, and climate-related risk. Results Between 2000 and 2019, cancer incidence increased significantly across Puerto Rico. Both crude and age-adjusted rates rose over time, with consistently high rates observed in urban centers such as Bayamón, San Juan, and Guaynabo, as well as in smaller municipalities like Aibonito and Hormigueros. Age-adjusted data further revealed high-risk counties such as Santa Isabel, Arroyo, and Villalba, potentially reflecting disparities in healthcare access or environmental exposures. In later years, rural and female-driven cancer hotspots emerged. Municipalities including Lajas, Ciales, and Sabana Grande exhibited both high cancer incidence and high SVI, indicating urgent need for intervention. In contrast, Guaynabo and Bayamón had high cancer rates despite low social vulnerability, while hazard-prone coastal areas like Rincón and Ponce showed elevated cancer rates and disaster vulnerability. Conclusion Tracking cancer incidence in Puerto Rico offers critical insight into excess mortality and health system challenges in the face of climate threats. This analysis highlights spatial patterns of high cancer burden and social vulnerability, providing evidence to guide targeted interventions and improve health system resilience. Identifying underserved populations affected by climate and health disparities can help advance equity in cancer outcomes and inform geographically tailored prevention strategies. Citation Format: Solimar Garcia-Molina, Melanie Diaz-Bonet, Erika Escabi-Wojna, Marievelisse Soto, Noreen Michaels, Nancy R. Cardona-Cordero, Ana P. Ortiz, Pablo Mendez-Lazaro. Social vulnerability index and climate extreme events impact on the excess mortality among Puerto Rican cancer patients [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A164.