Clinical and therapeutic characteristics and medical cost of managing cancer patients in Al-Anbar, Iraq: A cross-sectional study

BACKGROUND: Cancer is a complex disease that is one of the leading causes of death. This study aimed to investigate the clinical and therapeutic characteristics, as well as the medical cost of managing adult cancer patients in Al-Anbar city in Iraq from the patient's perspective. METHOD: This was a prospective cross-sectional study that was carried out at the Al-Anbar Oncology Centre between September and December 2021. Direct medical cost data includes the cost of treatment, healthcare professional visits, laboratory tests, and surgery. Furthermore, patients were contacted and asked to estimate the direct non-medical costs (transportation costs) connected with their disease, as well as describe side effects of their cancer therapy. Logistic regression was used to identify variables associated with higher cancer management costs. RESULTS: This study included 500 patients in total. The median overall management cost is 2,765.0 $ (IQR: 3,888.7$). The median cancer management cost differed statistically significantly depending on the stage of the disease, with stage two patients having a lower median cost than other patients (p < 0.05). Patients suffering from colon and brain cancer having significantly higher costs (p ≤ 0.05). The median duration of disease was 1.0 year (IQR: 1.0 year). More than half the patients (65.4 %) were at stages three and four. Breast cancer (among females), ovarian cancer (among females), and lymphoma were the most common types of cancer, accounting for 53.9 %, 10.5 %, and 8.6 %, respectively. Almost all patients (99.8 %) were undergoing chemotherapy. More than half of the patients (64.8 %) had surgery to manage their disease, and 16.6 % had radiotherapy as part of their treatment plan. The most widely utilized chemotherapy therapeutic classes were antimicrotubular and platinum analogues with 34.0 % and 33.6 %, respectively. The most common cancer therapy side effects were nausea and vomiting, hair loss, and appetite loss, with 85.2 %, 75.2 %, and 54.2 %, respectively. CONCLUSION: Breast cancer (in females), ovarian cancer (in females), and lymphoma are the most common types of cancer in Iraq. More research on the risk factors for these types of cancer is needed. Furthermore, additional economic studies from other perspectives are required to highlight the economic burden of cancer in Iraq.