Financial barriers related to breast cancer screening and treatment: A cross-sectional survey of women in Kenya

Background: Breast cancer is a leading cause of cancer mortality among women in Kenya. Regular screening and optimal treatments can reduce the burden from this disease, but the cost of health care is a barrier to accessing these services. The objective of this study is to assess barriers to breast cancer screening and treatment services, with special emphasis on economic aspects. Methods: We recruited 400 women with and 400 women without a diagnosis of breast cancer and conducted face-to-face interviews. We developed tailored instruments to capture demographics, socioeconomic factors, employment status, insurance coverage, barriers to seeking care, and treatment cost. Qualitative feedback was also sought from the participants. Results: Among women without breast cancer, the most commonly cited impediments to receiving medical care were cost (46.3 %) and transportation (23.3 %). For women with breast cancer, 53.8% reported that they had to forego care because of cost and 91.2 % reported that their diagnosis impacted household financial wellbeing. Additionally, about half the women (44.9 %) with insurance coverage indicated that the reimbursement received for medical costs was less than they expected to receive. Conclusion: For women both with and without diagnosed breast cancer, cost was a major concern in seeking medical services. Affordability and access to breast cancer screening and treatment need to be improved. Providing more comprehensive insurance coverage is a key solution.