Risk of financial catastrophe for breast cancer patients in Nigeria: A retrospective analysis

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-10-30 DOI:10.1016/j.amjsurg.2024.116053

Norah N. Zaza , Matt Caputo , Frances I. Uwechue , Sophia Okeke , Toluwanimi Aduloju , Zainab Adegbite , Chinenye Iwuji , Chukwumere Nwogu , Bindiya Sadarangani , Kristina Diaz , Egide Abahuje , Juliet S. Lumati

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引用次数: 0

Abstract

Introduction

Cancer imposes significant financial burden on patients in low and middle-income countries like Nigeria, where breast cancer (BC) is the most common cancer and has the highest mortality. This study aims to investigate the financial burden of BC care at Lakeshore Cancer Center (LCC) in Nigeria and identify risk factors for financial catastrophe (FC).

Methods

LCC was queried for uninsured patients diagnosed with breast cancers between 2013 and 2023, linked to cost data through chart abstraction of billing data and adjusted to 2023 USD. All costs were out-of-pocket costs (OOP) as all patients were uninsured. Risk for financial catastrophe was defined as OOP exceeding 20 % of Nigeria's 2023 per capita GDP ($467). Total OOP and risk for financial catastrophe were measured with descriptive statistics and stratified by clinical characteristics.

Results

352 BC patients (99 % female, median age 47, 41 % stage 4, 28 % stage 3) were included. 260 (74 %) patients risked financial catastrophe, despite only 30 % completing treatment. Patients with HER2+/HR + disease exhibited the highest treatment costs. Among patients that underwent multiple treatment modalities (n = 130), the average OOP was $17992 with 100 % risking financial catastrophe. The highest contributors to the cohort's total costs were chemotherapy (29 %), immunotherapy (18 %), and other drugs (12 %). Surgery contributed 7 %.

Discussion

Less than one-third of BC patients completed treatment, and the majority faced financial catastrophe, especially those with HER2+/HR + disease and patients who underwent multiple treatment modalities or immunotherapy. Targeted efforts are essential to ensure equitable access to quality cancer care while minimizing risk of financial catastrophe.

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尼日利亚乳腺癌患者的财务灾难风险：回顾性分析

导言癌症给尼日利亚等中低收入国家的患者带来了沉重的经济负担，而乳腺癌（BC）是最常见的癌症，死亡率也最高。本研究旨在调查尼日利亚湖滨癌症中心（LCC）乳腺癌治疗的经济负担，并确定导致经济灾难（FC）的风险因素。方法：查询 LCC 在 2013 年至 2023 年期间诊断为乳腺癌的未参保患者，通过图表抽取账单数据与成本数据关联，并调整为 2023 年美元。所有费用均为自付费用（OOP），因为所有患者均未参保。财务灾难风险被定义为自付费用超过尼日利亚 2023 年人均 GDP（467 美元）的 20%。结果共纳入了 352 名 BC 患者（99% 为女性，中位年龄为 47 岁，41% 为 4 期，28% 为 3 期）。尽管只有 30% 的患者完成了治疗，但仍有 260 例（74%）患者面临经济灾难风险。HER2+/HR+患者的治疗费用最高。在接受多种治疗方式的患者中（n = 130），平均 OOP 为 17992 美元，100% 的患者面临财务灾难风险。化疗（29%）、免疫疗法（18%）和其他药物（12%）的费用最高。讨论不到三分之一的 BC 患者完成了治疗，大多数患者面临经济灾难，尤其是那些患有 HER2+/HR + 疾病和接受多种治疗方式或免疫疗法的患者。有针对性的努力对于确保公平获得优质癌症治疗，同时最大限度地降低经济灾难风险至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.