Financial toxicity and psychosocial distress of breast and cervical cancer patients at a tertiary healthcare facility in south-western Nigeria

Abstract

Breast and cervical cancers are leading causes of morbidity and mortality in women worldwide. The treatment and management of these illnesses are accompanied with financial toxicity and psychological distress to the patients. This study investigated financial toxicity and psychosocial distress of breast and cervical cancer patients at the University College Hospital, Ibadan, Nigeria. This was a descriptive cross-sectional study that employed a convergent parallel, mixed-methods design. The study was conducted among 105 breast and cervical cancer patients receiving treatment between June and August, 2021. Data were obtained using a semi-structured, interviewer-administered questionnaire and in-depth interview guide. The quantitative data were analyzed using descriptive and inferential statistics, and qualitative data were analyzed using thematic analysis. The mean age of the respondents was 48.8 ± 10.0 years, and almost half of the participants (45%) were aged between 51 and 60 years. Most of the respondents (67.6%) were breast cancer patients, while (32.4%) were cervical cancer patients. This study found that (96.2%) of the respondents experienced high financial toxicity, and (73.3%) of the respondents had a high level of psychosocial distress. Financial toxicity was the strongest predictor of psychosocial distress (Wald χ² = 87.28, p < 0.001), indicating that higher financial toxicity was associated with high psychosocial distress. Factors that contributed to the financial toxicity and psychosocial distress as deduced from the qualitative interviews were high cost of treatment, loss of income, and negative body image. Breast and cervical cancer patients experience a high level of financial toxicity and psychosocial distress. Multi-component interventions are needed to defray costs, improve psychological well-being, reduce disparities in treatment outcomes, and improve the quality of cancer care.