Cancer Care Delivery and Financial Barriers Among Patients in Lebanon: A Descriptive Multicenter Cross-Sectional Study.

Background Cancer care in Lebanon is provided within a fragmented health system affected by economic instability, incomplete insurance coverage, and variable access to diagnostic and treatment services. These factors may influence the timely initiation of treatment, continuity of care, and the delivery of evidence-based oncology care. This study aimed to characterize access to cancer care in Lebanon by evaluating treatment delays, socioeconomic burdens, health coverage, treatment supply sources, and concordance with National Comprehensive Cancer Network (NCCN) recommendations among adults receiving hospital-based cancer therapy. Methods A descriptive cross-sectional multicenter study was conducted in five hospitals in Lebanon between July 2024 and June 2025. A total of 244 adult Lebanese patients receiving active cancer treatment were included. Data were collected using a structured questionnaire that covered socioeconomic characteristics, cancer-related factors, and treatment-related factors. Results Most participants were women (n=144, 59.0%), and the largest age group was 60-74 years (n=113, 46.3%). More than half were unemployed (n=138, 56.6%) and lacked medical insurance coverage (n=139, 57.0%). Household income substantially decreased for 80.7% (n=197) of the participants, with reliance on multiple coping strategies, including family support, savings, debt, donations, and asset sales. Breast cancer was the most common diagnosis (n=66, 27.1%), followed by colorectal (n=37, 15.2%) and lung (n=36, 14.8%) cancer. Advanced-stage disease was common, with 50.4% (n=123) presenting with stage IV disease and 22.1% (n=54) presenting with stage III disease. Treatment initiation delays exceeding two weeks were reported by 52.5% (n=128) of the participants, mainly related to pre-treatment procedures, financial constraints, and diagnostic delays. Most patients received their planned cancer therapies, with the treatment supplied primarily by hospitals and the Ministry of Public Health. Overall, 84.8% (n=207) of patients received NCCN guideline-concordant treatment. Conclusions Hospital-based cancer care in Lebanon remains limited by socioeconomic barriers and incomplete financial protection. However, among patients who accessed active oncology care, guideline-concordant treatment was largely maintained. These findings underscore important challenges in financial protection, diagnostic pathways, and continuity of oncology services that warrant further attention in Lebanon.