10.3390/polym8030084

Vollständiger Abstract

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<b>Background/Objectives</b>: In Lebanon, the economic crisis since 2019 has severely strained healthcare infrastructure, yet its impact on cancer treatment adherence remains incompletely characterized. This study assessed factors associated with treatment delay and regimen modification to identify barriers to optimal cancer care among Lebanese patients. <b>Methods</b>: This multicenter, cross-sectional study was conducted in five tertiary hospitals in Beirut, Lebanon, between 13 June 2024, and 27 June 2025. Demographic, clinical and treatment data were collected via a structured questionnaire. Bivariate and multivariable binary logistic regression analyses were performed to identify independent predictors of treatment delay (>2 weeks) and incomplete treatment regimens. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) are reported. <b>Results</b>: A total of 244 patients were enrolled in the study. The study population was predominantly female (59.0%) and aged ≥60 years (60.2%). Advanced disease was common, with 50.4% of patients presenting with stage IV disease. Financial vulnerability was widespread: 72.6% reported monthly household incomes below USD 1000, 88.1% reported a decline in income due to the economic crisis, and 39.3% relied on unstable income sources. Overall, 52.5% of patients experienced treatment initiation delays, and 9.0% received incomplete or dose-reduced regimens. On multivariable analysis, reliance on unfixed income independently predicted treatment delay (aOR 2.55, 95% CI 1.42-4.59; <i>p</i> = 0.002), lack of health insurance (aOR 1.91, 95% CI 1.08-3.39; <i>p</i> = 0.026) and pre-treatment surgical costs also increased the odds of delay (aOR 9.03, 95% CI 2.57-31.7; <i>p</i> = 0.001). For incomplete treatment, unfixed income remained an independent predictor (aOR 2.09, 95% CI 1.16-5.79; <i>p</i> = 0.015). A lack of insurance (aOR 5.62, 95% CI 1.22-25.9; <i>p</i> = 0.027) and high laboratory costs (>USD 150 per session) were also associated with incomplete regimens (aOR 1.62, 95% CI 1.02-2.57; <i>p</i> = 0.041). <b>Conclusions</b>: In Lebanon's crisis context, financial instability was a key factor associated with deviations in cancer treatment. These findings highlight the need for strengthened insurance coverage and subsidization of diagnostic and treatment-related costs to ensure timely and continuous oncologic care.

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