Island communities are particularly susceptible to extreme weather events, which can devastate socio-ecological systems and healthcare infrastructures, exacerbating challenges for people with cancer and cancer caregivers. This study examines the concerns, perceptions, and experiences of people with cancer and caregivers in Puerto Rico related to climate hazards and extreme weather events.

A cross-sectional study was conducted in 2023 with a sample of 412 people with cancer and 162 cancer caregivers in Puerto Rico aged ≥21 years. Data on socio-demographics, extreme weather event experiences, and climate change beliefs were collected. Statistical analyses evaluated factors associated with concern about climate change and worry about health in the face of climate change. Analyses were performed using Stata Statistical Software.

Participants expressed concern about climate change (90.8%) and worry about their health (81.0%). Experiencing extreme heat events was associated with increased concern (aOR = 4.72; 95% CI: 1.52–14.6). People who reported experience with flooding events were more likely to worry about their health (aOR = 1.72; 95% CI: 1.07–2.79).

This study underscores concern among people with cancer and caregivers in Puerto Rico with climate change's potential health impacts. Understanding vulnerabilities, risks and perceptions can help design targeted strategies to address specific needs of this population.

This study calls for improvement in climate extreme event awareness and integration of this population’s needs into planning and preparedness.