Abstract 19: Scoping Review on Cancer Care Financing in Nigeria

Abstract Purpose: Cancer presents a huge financial burden to patients globally. This burden is particularly significant in low- and middle-income countries (LMICs) with high poverty rates and minimal sustainable funding models. In Nigeria—the most populous African country with over 100,000 new cancer cases yearly—out-of-pocket costs for cancer care exceed the GDP per capita, with most patients at risk of financial catastrophe. This scoping review aims to map existing evidence on available cancer financing options for patients in Nigeria across the entire spectrum of cancer care. Methods: We conducted a comprehensive search of the PUBMED database using a search strategy based on the core concepts of “healthcare financing”, “cancer patients” and “Nigeria”. There were no restrictions based on publication timing or study design; however, gray literature was excluded. Abstract screening, full-text review and data extraction were conducted by two independent reviewers, and conflicts were reconciled by a third reviewer, or by consensus where necessary. Data extraction, synthesis and analysis were done following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Results: From 408 screened articles, 19 studies met the eligibility criteria, covering a time frame of 2008 to 2024. Most studies included (14/19) were original research and based in Urban (14/19) settings. Most covered financing options for cancer treatment (16/19) with fewer studies capturing prevention, screening and diagnosis. The available sources of cancer financing can be classified into out-of-pocket, insurance (public and private), family/relative support, loans and donor funding. Importantly, OOP was the predominant source in all studies, where indicated. All papers reported negative impact of costs on treatment, including treatment abandonment and catastrophic healthcare spending. Studies unanimously recommended expanding private and public insurance coverage for financial risk protection. Conclusion: The evidence suggests that healthcare financing options are grossly limited for cancer patients in Nigeria with most patients paying out-of-pocket. There is a need for more research on the financing options available to patients across different settings especially in rural and underserved regions of the country with more rigorous study designs to capture financing options for direct and indirect costs of cancer care. Citation Format: Oluwasegun Afolaranmi, Sophia Okeke, Toluwanimi S. Aduloju, Moyinoluwa Akinwunmi, Emmanuel Uduigwome, Egide Abahuje, Elieen Wafford, Kristina Diaz, Funmilola Wuraola, Chinenye Iwuji, Juliet S. Lumati. Scoping Review on Cancer Care Financing in Nigeria [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 19.