title: Financial barriers to utilization of screening and treatment services for breast cancer: an equity analysis in Nigeria.
abstract: OBJECTIVE
  To determine financial barriers that impede the utilization of screening and treatment services for breast cancer among Nigerian women from different socioeconomic groups.
  
  
  METHODS
  A descriptive study was carried out in 2013 among women attending the oncology clinic of a tertiary institution in Enugu, Southeast Nigeria. Data were collected from 270 women using an interviewer-administered questionnaire. The links between the influence of socioeconomic factors on barriers to the utilization of breast cancer screening and treatment services were examined.
  
  
  RESULTS
  A total of 270 women were studied. The mean age was 34.69 (Standard deviation = 5.07) years. Half of the study participants were single 141 (51.3%), while 105 (38.2%) were married. Cost of medical treatment and not having insurance coverage was major financial barriers to utilization of screening and treatment services. The least poor and poor socioeconomic status (SES) groups utilized screening services and treatment more frequently than the very poor and poorest SES groups ( P = 0.034). There was no significant difference in the utilization of the different treatment options among the different socioeconomic groups with the exception of surgery (χ² = 11.397; P = 0.000).
  
  
  CONCLUSIONS
  Financial barriers limit the ability of women, especially the poorest SES group, to utilize screening and treatment services for early diagnosis and treatment of breast cancer. Interventions that will improve financial risk protection for women with breast cancer or at risk of breast cancer are needed to ensure equitable access to screening and treatment services.
authors: Department of Health Administration and Management, University of Nigeria, Enugu; Department of Nursing Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria.
authors: I L
authors: IL
authors: Okoronkwo
authors: P
authors: P
authors: Ejike-Okoye
authors: A U
authors: AU
authors: Chinweuba
authors: A C
authors: AC
authors: Nwaneri
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D016504:Breast Self-Examination / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data; D008408:Mastectomy / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D009549:Nigeria; D010808:Physical Examination / Q000191:economics / Q000706:statistics & numerical data; D011878:Radiotherapy / Q000191:economics / Q000706:statistics & numerical data; D012923:Social Class; D012959:Socioeconomic Factors; D014186:Transportation / Q000191:economics; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents