Study on economic burden and its influencing factors of patients with cervical cancer and precancerous lesions in Inner Mongolia Autonomous Region

Background: The Inner Mongolia Autonomous Region, located in the northern part of China, and characterized by high-altitude conditions averaging 3556 m above sea level, is characterized by the poor healthcare system and socioeconomic factors that influence its relatively underdeveloped status. Previous studies have indicated that cervical cancer is one of the common gynecological malignancies. This studied the economic burden of patients with cervical cancer and precancerous lesions within the Inner Mongolia Autonomous Region, providing a scientific basis for the development and implementation of cervical cancer prevention and control measures locally. Methods : This was a cross-sectional, population-based, and multi-center survey. We selected patients with precancerous lesions and cervical cancer in the initial stage, radiotherapy stage, recurrence stage and follow-up review stage by using multi-stage stratified sampling method to collected the basic information and overall cost data from patients in Inner Mongolia Autonomous Region from August 2020 to June2021. 151 patients with cervical cancer and cervical precancerous lesions aged 23-76 years old were invited to participate in investigation by questionnaires. SPSS 20.0 was used for statistical analysis. Results: The average age of 151 patients with cervical cancer and precancerous lesions was (50.7±11.6) years, and the direct medical costs of patients with cervical cancer and precancerous lesions at different treatment stages were statistically different (P<0.05). The direct medical costs gradually increased as the cervical cancer stages progressed (initial stage, radiotherapy stage, recurrence stage, and follow-up review stage). After the direct medical costs were reimbursed by urban workers' or residents' medical insurance, the economic burden on patients at the radiotherapy stage was the heaviest, reaching 0.5 and 0.49 times the total annual per capita income. The highest economic burden after being reimbursed by rural medical insurance on patients at the recurrence stage could reach 2.05 times the total annual per capita income. Multi-factor logistic regression analysis showed that different occupations, education levels, treatment stages, reimbursement amounts, and days of hospitalization all affected the direct economic burden of cervical cancer (P<0.05). Conclusions: The economic burden on patients with cervical cancer and precancerous lesions at different stages varied greatly. Marital status and reimbursement amount had a greater impact on the economic burden of patients in the Inner Mongolia Autonomous Region.