Financial toxicity in cancer patients in Senegal: A cross-sectional study in two care facilities.

Abstract

e23031 Background: Cancer is a major public health issue due to its rising incidence and high mortality rates, despite significant therapeutic advancements (1). Innovative diagnostic and therapeutic tools have been developed, helping to improve the prognosis outcomes. However, the increasing costs of cancer care negatively impact patients’ quality of life. In low-income countries such as Senegal, insufficient funding of public healthcare worsens the situation, further exposing patients to financial toxicity. Additionally, many cancer patients live below the poverty line, thus accentuating their financial difficulties .This study is prompted by the need to evaluate the financial toxicity linked to cancer in patients receiving care in two health centers in Senegal. Methods: We interviewed patients with cancer in two care facilities in Senegal (Saint-Louis Regional Hospital and Dalal Jam University Hospital in Dakar). The study period was between August 1 and September 31, 2024. Patients undergoing specific cancer treatment were eligible. The questionnaire explored demographic parameters, site and stage of the tumor, and financial indices, including methods of healthcare financing and coping strategies. It was administered face-to-face by health personnels. Free and informed consent was obtained from all the patients. Descriptive statistics was used to present the results. Results: We collected data from 72 patients with a mean age of 48.74 years. The majority were women (82%) and lived outside the capital (85%). Breast cancer was the most common site (50%). Patients received chemotherapy in 94.4% of cases and radiotherapy in 54.2%. After a cancer diagnosis, 42 patients (58.3%) stopped working entirely, while 33.3% continued working part-time. Patients paid out of pocket for their care in 86.1% of cases. Additionally, 78% of patients reported that direct treatment costs were the primary challenge. Financial constraints caused 19.4% of patients to miss at least one appointment. Conclusions: This study underscores the urgent need for solutions to address financial toxicity in Senegal. Strategies such as implementing universal health coverage, reducing costs of anticancer drugs, and raising awareness among oncologists and patients could improve outcomes. Keywords: financial distress, financial hardship, Senegal, cancer treatment, global oncology.