The effect of natural disasters on cancer care: a systematic review

Ralph Xiu Gee Man*, David A. Lack, Charlotte E. Wyatt, Virginia Murray

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

26 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)e482-e499
JournalThe Lancet Oncology
Issue number9
Publication statusPublished - Sep 2018

Bibliographical note

Funding Information:
To the best of our knowledge, this Review is the first paper to assess the available evidence on the effect of natural disaster events on cancer care, building on the suggestions that have been set out in the Sendai framework, 3 which states that “people with life-threatening and chronic disease, due to their particular needs, should be included in the design of policies and plans to manage their risks before, during, and after disasters including having access to life-saving services”. 3 We support this suggestion, emphasising the need for patients with cancer to be included in disaster management. Oncology is a specialty that relies heavily on continuity. Treatment regimens are individualised, need to be given within specific time periods, and require a specialised multidisciplinary input. This requirement of continuity makes this disease specialty particularly susceptible to the effects from natural disasters. We have shown that natural disasters worsen outcomes for patients with cancer and cause great psychological distress to them, their families, and the staff providing their care. Oncology services can use this Review as a basis on which to formulate contingency plans to prepare and support patients with cancer, and help form the foundations for further research in the field. Contributors RX-GM conceived the study. RX-GM and VM were involved in the study design. RX-GM, DAL, and CEW were involved in the data collection process. RX-GM and DAL were involved in data analysis. All authors were involved in the preparation of the manuscript. Declaration of interest We declare no competing interests. Acknowledgments VM is a scientific committee member for Integrated Research on Disaster Risk, co-sponsored by the International Science Council and the United Nations Office for Disaster Risk Reduction (Beijing, China).

Publisher Copyright:
© 2018 Elsevier Ltd


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