The economic burden of cervical cancer in Addis Ababa: a matched case-control study

Cervical cancer poses a major global health challenge with significant financial burdens, especially in advanced care settings. In developing countries like Ethiopia, limited evidence exists on its economic impact. The objective of this study was to evaluate the economic burden of cervical cancer in Addis Ababa, Ethiopia.

A matched comparative cost-of-illness study using a matched case-control framework was employed at tertiary oncology centers from July 1st to September 30th, 2023. Participants were consecutively recruited. Data was collected using an interviewer-administered questionnaire developed after a literature review, and medical records were abstracted. Data entry was done via Epi Info v.7.2.5, followed by cleaning, transformation, and export to IBM SPSS v.26 for further analysis. Descriptive statistics, Student's t-test, and Tukey's biweight regression were applied using SPSS and R (v4.2.2). Statistical significance was determined at p < 0.05 with a 95% confidence interval.

A total of 932 participants were enrolled in the study, comprising 466 cases and 466 controls. The findings indicated that the average total annual cost for cervical cancer per patient was INT$3196.27 in the first year, decreasing to INT$2235.86 in subsequent years. Direct medical costs were the primary contributors, amounting to INT$2638.05 in the first year and INT$1898.02 thereafter. Specifically, diagnosis and treatment represented the largest expenses in both the first year and the post-first-year periods. In the first year, diagnosis costs were the highest, averaging INT$1548.16 (± SD INT$1946.87), followed by treatment costs at INT$1004.18 (± SD INT$1403.45). In the post-first-year period, diagnosis costs remained significant at INT$1020.91 (± SD INT$2344.55), while treatment costs averaged INT$796.26 (± SD INT$1001.36). Key factors independently associated with higher total annual costs included larger household size (β = 492 0.82, p < 0.05), presence of comorbidities (β = 834.96, p < 0.001), lack of social support (β = 627.48, p < 0.001), poor diet (β = 740.27, p < 0.001), and advanced cancer stage (β = 1324.12, p < 0.001).

Cervical cancer imposes a significant economic burden, with average annual costs of 3196.27 INT$ in the first year and 2235.86 INT$ afterward. Direct medical costs dominate expenses, with household size, comorbidities, lack of social support, poor diet, treatment timing, and advanced-stage disease were associated with higher total annual costs. Targeted interventions like early diagnosis and financial support are essential to reduce this burden.