Evidence map›Paper›PMID 41824077›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

Association between time to treatment and financial toxicity among women with breast cancer in Ethiopia: a multicentre study in a low-resource setting.

Anteneh Ayelign Kibret, Heng Jiang, Edom Seife Woldetsadik, Miliyard Demeke Tafese, Biniyam Tefera Deressa, Chaojie Liu

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Anteneh Ayelign KibretSchool of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia. A.Kibret@latrobe.edu.au.
Heng JiangSchool of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.
Edom Seife WoldetsadikCollege of Health Sciences, Department of Oncology, Addis Ababa University, Addis Ababa, Ethiopia.
Miliyard Demeke TafeseJimma Oncology Centre, Jimma University, Jimma, Ethiopia.
Biniyam Tefera DeressaAdama Hospital Medical College, Adama, Ethiopia.
Chaojie LiuSchool of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBreast cancer imposes a substantial financial burden on patients, especially in low-income countries like Ethiopia where out-of-pocket (OOP) payments dominate health financing. This study aimed to assess the association between time to treatment initiation and financial toxicity (FT), among women with breast cancer in Ethiopia.

methodsA cross-sectional study was conducted from July to September 2024 among 458 women receiving breast cancer care at three tertiary hospitals in Ethiopia. Participants were interviewed using a validated Amharic version of the COST-FACIT tool, with additional data obtained from interviews and clinical records. The primary outcome was FT score, which ranged from 0 to 44, with a lower score indicating greater financial toxicity. Multivariable linear regression was used to assess the association between FT and the total treatment interval (TTI) from symptom recognition to treatment initiation, adjusting for sociodemographic, clinical, health insurance, and cost-coping behavioral factors.

resultsThe median FT score was 10 (IQR:5 to 16), indicating a high level of financial toxicity among the study participants. Most participants (71%) had a TTI longer than 90 days, which was associated with higher financial toxicity (median FT score 9 compared with 14 in those with ≤ 90 TTI days, p < 0.001). Longer TTI was a significant predictor (B = -2.50; 95% CI: -4.06 to -0.95; p = 0.002) of higher financial toxicity, after adjustment for variations of covariates. Other significant predictors of higher financial toxicity included younger age (< 40 years: B = -4.37; p = 0.001; 40-59 years: B = -3.53; p = 0.003), lower income (≤ 2,100 ETB: B = -5.40; 2,101-3,254 ETB: B = -3.91; p < 0.001), rural residence (B = -2.28; p = 0.039), on active treatment (B = -3.59; p = 0.001), and reliance on borrowed/assisted financing for OOP (B = -4.59; p < 0.001). There also existed FT disparities across the three hospitals.

conclusionFinancial toxicity is evident in Ethiopian women with breast cancer, particularly among those with lower socioeconomic status. Longer TTI is associated with higher financial toxicity. These findings highlight the limited role of the current health insurance arrangement in addressing the level and inequality of financial toxicity associated with breast cancer care in Ethiopia.

Indexed as

Breast NeoplasmsCost of IllnessHealth ExpendituresTime-to-TreatmentAdultAgedCross-Sectional StudiesEthiopiaFemaleHumansMiddle AgedResource-Limited SettingsTime FactorsBreast cancerEthiopiaFinancial toxicityTreatment delay

Identifiers

PMID41824077
PMCPMC12987774

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