Burden of cervical cancer in Northern Nigeria

Abstract

Background: Data regarding burden of illness borne by women affected with cancer of the cervix (CaCvx) has been largely anecdotal. This study aimed to evaluate disability and cost burden of the illness in northern Nigeria.

Materials and Methods: Cost of illness was determined using the bottom‑up approach and involved estimating costs of managing various stages of the illness while disability adjusted life year (DALY) was estimated sing CaCvx survival data from northern Nigeria.

Results: Overall cost of illness ranged from ₦191,338 ($524) to ₦1,001,298 ($2,743) for local to metastatic diseases, respectively. Of these, direct medical costs accounted for up to 75.4% while indirect costs accounted for up to 48% in different stages of the disease. Productivity losses ranged from 18.3% to 43.1%, while surgical, medical, and radiotherapies accounted for losses between 37.2% and 46%. Estimated DALY was 269 years/100,000 women with cost/DALY saved on treatment estimated at between $19 and $1,443 for different stages. At the discounted rate, it was estimated that it would be 16 to 902 times cheaper to screen for the disease than to treat (P < 0.0001).

Conclusion: Though burden of illness borne by women with CaCvx in northern Nigeria is similar to that borne by women in other developing countries, it is still too high; and the only panacea to this is institution of early screening programs and immunization. In addition, concerted effort is needed to ensure extension of health insurance coverage for cancer therapy and increase in availability of radiotherapy service as a means of reducing waiting times for treatment.

Keywords: Cervical cancer; cost of illness; disability adjusted life year; productivity