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Financial and food security challenges of Egyptian women undergoing breast cancer treatment

Supportive Care in Cancer volume 28, pages 5787–5794 (2020)Cite this article

Abstract

Background

Breast cancer treatment is an established cause of financial toxicity, and associated costs may contribute to higher mortality and morbidity rates. In Egypt, breast cancer incidence and mortality rates are among the highest in the Middle East. Late-stage diagnosis is common, and disease occurs at an earlier age than in Europe and North America. Out-of-pocket payments are the primary means of financing healthcare in Egypt, and socioeconomic factors have been shown to significantly impact access to cancer screening and treatment.

Methods

An observational cross-sectional study was conducted among breast cancer patients at Ain Shams University Hospitals in Cairo from 2013 to 2015.

Results

One hundred women with breast cancer participated. There was a high need for financial assistance (66.0%) and patients with financial needs had great difficulty affording medications (80.0%). A number of patients had lost their jobs following diagnosis, with 32.7% employed prior to diagnosis and 15.3% afterwards. Nearly one-half of participants were classified as food insecure, and nearly one-third reported difficulty affording transportation costs.

Conclusions

This is the first study to describe socioeconomic needs and financial impact among a cohort of Egyptian women undergoing breast cancer treatment. The findings highlight the financial impact of breast cancer treatment on a cohort of Egyptian breast cancer patients and the need for a multidisciplinary approach to help them access and mitigate the costs of treatment. Recommendations include implementing patient financial navigation services and producing printed materials to inform patients of resources to help mitigate the treatment’s financial impact.

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Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgments

We would like to thank the following individuals for their contributions in collecting the data: Dala Badreddine, Mahmoud Yousef, and Mohamad Al Khayat.

Funding

This work was supported by The Olayan Group and National Cancer Institute (P30 CA008748).

Author information

Affiliations

  1. Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Francesca Gany, Claudia Ayash, Noor Raad, Minlun Wu, Nicole Roberts-Eversley & Hani Mahmoud

  2. Department of General Surgery, Ain Shams University, Cairo, Egypt

    Yousef Fouad, Yara Fahmy, Hadeel Asar, Ahmed Salama & Mohamed El-Shinawi

Authors
  1. Francesca Gany
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  2. Claudia Ayash
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  3. Noor Raad
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  4. Minlun Wu
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  11. Mohamed El-Shinawi
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Corresponding author

Correspondence to Claudia Ayash.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Editorial support

The authors would like to thank Sonya J. Smyk, Memorial Sloan Kettering Cancer Center, for editorial support. She was not compensated beyond her regular salary.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee Ain Shams University (00006379) institutional review board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. A data agreement was then signed by Memorial Sloan Kettering Cancer Center and Ain Shams University Hospital.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Cite this article

Gany, F., Ayash, C., Raad, N. et al. Financial and food security challenges of Egyptian women undergoing breast cancer treatment. Support Care Cancer 28, 5787–5794 (2020). https://doi.org/10.1007/s00520-020-05426-9

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  • DOI: https://doi.org/10.1007/s00520-020-05426-9

Keywords

  • Breast cancer
  • Egypt
  • Financial toxicity
  • Food insecurity
  • Patient navigation