Guest host, Dr. John Sweetenham, associate director for Clinical Affairs at UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center, and Dr. Leticia Nogueira, a senior principal scientist in the Surveillance & Health Equity Science Department at the American Cancer Society, discuss the threat of climate change on cancer prevention and control efforts, and how oncologists can mitigate against the risks of climate change. Transcript:   Dr. John Sweetenham: Hello. I'm John Sweetenham, the associate director for Clinical Affairs at UT Southwestern's Harold C. Simmons Comprehensive Cancer Center and guest host of the ASCO Daily News Podcast. Today, we'll be discussing the impact of climate change on cancer prevention and control efforts in the United States and beyond. Climate change has increased cancer risk through increased exposure to carcinogens after extreme weather events, such as hurricanes and wildfires.   In addition, these major events disrupt cancer treatment, which has, until recently, poorly defined effects on cancer outcome. Dr. Leticia Nogueira, a senior principal scientist in the Surveillance & Health Equity Science Department at the American Cancer Society joins us today to discuss the threat from climate change and the importance of disaster preparedness and mitigation efforts by cancer centers. Our full disclosures are available in the show notes, and disclosures relating to all episodes of the podcast can be found at asco.org/podcasts. Dr. Nogueira, it's great to have you on the podcast today.   Dr. Leticia Nogueira: Thank you. It's my pleasure to be here.   Dr. John Sweetenham: Dr. Nogueira, when Hurricane Maria struck Puerto Rico in 2018, it closed several factories that provided life-saving IV fluids to US hospitals, causing shortages in cancer centers nationwide. That's really just one example of how an extreme weather event can compromise health care delivery. How is climate change impacting cancer outcomes today?   Dr. Leticia Nogueira: Yes. Climate change is impacting not only the frequency, but also the behavior of extreme weather events, which makes it harder for communities and institutions to prepare and respond to these events. And disruptions in the supply chain, as we saw with Hurricane Maria, are just one example how extreme weather events can impact access to cancer care.   As we saw recently with the tornadoes in Kentucky and the winter storms in Texas, extreme weather events can also damage medical infrastructure. And because cancer diagnosis and treatment can lead to several physical, psychological, and socioeconomic consequences, individuals who have been diagnosed with cancer have increased sensitivity to the health threats of climate change.   Dr. John Sweetenham: Thanks. And you led a study, which was published in JAMA couple of years ago, that investigated whether hurricane disasters that occurred during the time that patients were receiving radiation therapy for non–small cell lung cancer were associated with the poorer outcome in that patient group. Could you comment on that study and, furthermore, maybe comment on whether you think that other modalities of treatment are also likely to be compromised by natural disasters?   Dr. Leticia Nogueira: Yes, of course. In that study, we chose to focus on radiation therapy because it needs to be given daily, and it's highly dependent on electricity, which is frequently disrupted during hurricanes. But really, any cancer treatment modality is vulnerable to disasters that lead to power outages, supply chain disruptions, or damaged medical infrastructure, and that includes surgery, chemotherapy, immunotherapy, any cancer treatment modality.   Dr. John Sweetenham: That's for sure. And I guess, also, I'm not sure whether you have any data specifically related to this, but I'd be interested to know if you have any information about the effects of these disasters on screening programs, for example, and the downstream consequ