The Cancer Burden on Patients and Their Families in a Resource-Restricted Country: A Cross-Sectional Survey Study From Georgia.

Abstract

IntroductionPatients and their families face financial difficulties during cancer care. This study aims to assess patients' unmet needs and financial challenges during diagnosis and treatment, representing the first research in the Republic of Georgia to address these economic issues.MethodsIn this multicenter, retrospective, observational study, a questionnaire was distributed, and clinical data were collected from 181 patients undergoing active cancer treatment across 7 tertiary hospitals. The primary outcomes of the study were the patient-reported experience of cancer-related financial burden on the family and the frequency of debt taken for cancer diagnosis or treatment.ResultsThe median age was 63, with 55.2% being female. Most patients (135/181, or 74.5%) reported a "moderate" or "heavy" economic burden from cancer care. During diagnosis and treatment, 129 patients (71.3%) incurred out-of-pocket costs, and 44.2% took out loans for care, with 10 patients (5.6%) doing so multiple times. The most common reason for debt (76/181) was to cover diagnostic procedures. Only 57 patients (31.5%) reported stable employment at the time of the survey, and among the 149 employed/self-employed, 50 (33.5%) experienced work-related issues due to cancer. Younger patients (≤65) had a tendency to take on debt more frequently (49.5%) compared to older (>65) patients (37%), but this difference was not statistically significant (P-value .097).ConclusionCancer care in Georgia imposes a heavy financial burden, with significant out-of-pocket costs for most patients. Improved access to financial assistance is required to better avoid potential inequities.