Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern Nigeria

Abstract The health-related quality of life (HRQoL) and financial toxicity (FT) of women with gynecological cancers in sub-Saharan Africa have not been sufficiently explored. This study assessed predictors of HRQoL and FT, as well as the effect of FT on HRQoL, among affected women in Nigeria. This c...

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Main Authors: Chibuzor F. Ogamba, Adedayo Joseph, Ayodeji Kayode Adefemi, Chidike Onyedikachi Ezegwui, Ajay Major, Rasaq Oluwagbemiga Jimoh, Michael Osahumen Orhue, Michael Chudi Ezeanochie, Boniface Uji Ago, Linda Ogochukwu Amah, Emeka Emmanuel Okoh, Courage Osamudiamen Idahor, Mazpa Ejikem, Alexander Clive Tinworth, Charilaos Zisou, Nwamaka N. Lasebikan
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13763-0
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author Chibuzor F. Ogamba
Adedayo Joseph
Ayodeji Kayode Adefemi
Chidike Onyedikachi Ezegwui
Ajay Major
Rasaq Oluwagbemiga Jimoh
Michael Osahumen Orhue
Michael Chudi Ezeanochie
Boniface Uji Ago
Linda Ogochukwu Amah
Emeka Emmanuel Okoh
Courage Osamudiamen Idahor
Mazpa Ejikem
Alexander Clive Tinworth
Charilaos Zisou
Nwamaka N. Lasebikan
author_facet Chibuzor F. Ogamba
Adedayo Joseph
Ayodeji Kayode Adefemi
Chidike Onyedikachi Ezegwui
Ajay Major
Rasaq Oluwagbemiga Jimoh
Michael Osahumen Orhue
Michael Chudi Ezeanochie
Boniface Uji Ago
Linda Ogochukwu Amah
Emeka Emmanuel Okoh
Courage Osamudiamen Idahor
Mazpa Ejikem
Alexander Clive Tinworth
Charilaos Zisou
Nwamaka N. Lasebikan
author_sort Chibuzor F. Ogamba
collection DOAJ
description Abstract The health-related quality of life (HRQoL) and financial toxicity (FT) of women with gynecological cancers in sub-Saharan Africa have not been sufficiently explored. This study assessed predictors of HRQoL and FT, as well as the effect of FT on HRQoL, among affected women in Nigeria. This cross-sectional study investigated 574 women with gynecological cancers receiving care at various stages at five academic hospitals in southern Nigeria between June 2022 and September 2024. HRQoL and FT were evaluated using the FACT-G and FACIT-COST tools, respectively. Multivariable linear regression models estimated the associations of patient characteristics with HRQoL and FT and the effect of FT on HRQoL. Most women experienced FT. After multivariable adjustments, unemployed women, women with ovarian and uterine cancers and choriocarcinoma, higher disease stages, and worse ECOG status had worse HRQoL. Conversely, women in remission had better HRQoL. FT was worse with stages III and IV disease and in those on active treatment. However, older women, those with health insurance, higher income, ovarian cancer and choriocarcinoma had better FT. FT varied linearly with HRQoL, with better HRQoL per unit better FT. This effect was stronger in those with a first tumor, those in pre-treatment and those in remission. Our findings identify possible predictors of HRQoL and FT and suggest potential benefits of reducing FT on the HRQoL of women with gynecological cancers in Nigeria.
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spelling doaj-art-a556f6ce4cdf4cf6aec91e7c976af9eb2025-08-20T03:05:22ZengNature PortfolioScientific Reports2045-23222025-07-0115111410.1038/s41598-025-13763-0Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern NigeriaChibuzor F. Ogamba0Adedayo Joseph1Ayodeji Kayode Adefemi2Chidike Onyedikachi Ezegwui3Ajay Major4Rasaq Oluwagbemiga Jimoh5Michael Osahumen Orhue6Michael Chudi Ezeanochie7Boniface Uji Ago8Linda Ogochukwu Amah9Emeka Emmanuel Okoh10Courage Osamudiamen Idahor11Mazpa Ejikem12Alexander Clive Tinworth13Charilaos Zisou14Nwamaka N. Lasebikan15Nuffield Department of Population Health, University of OxfordNSIA-LUTH Cancer Centre, Lagos University Teaching HospitalDepartment of Obstetrics and Gynaecology, Lagos State University Teaching HospitalDepartment of Obstetrics and Gynaecology, University of Nigeria Teaching HospitalDivision of Haematology, Department of Medicine, University of Colorado School of MedicineFaculty of Clinical Sciences, College of Medicine, University of LagosDepartment of Obstetrics and Gynaecology, University of Benin Teaching HospitalDepartment of Obstetrics and Gynaecology, University of Benin Teaching HospitalDepartment of Obstetrics and Gynaecology, University of Calabar Teaching HospitalUniversity of NottinghamNnamdi Azikiwe University Teaching HospitalNottingham University HospitalDepartment of Anaesthesiology, SUNY Downstate Health Sciences UniversityNuffield Department of Population Health, University of OxfordNuffield Department of Population Health, University of OxfordDepartment of Radiation Oncology, University of Nigeria Teaching HospitalAbstract The health-related quality of life (HRQoL) and financial toxicity (FT) of women with gynecological cancers in sub-Saharan Africa have not been sufficiently explored. This study assessed predictors of HRQoL and FT, as well as the effect of FT on HRQoL, among affected women in Nigeria. This cross-sectional study investigated 574 women with gynecological cancers receiving care at various stages at five academic hospitals in southern Nigeria between June 2022 and September 2024. HRQoL and FT were evaluated using the FACT-G and FACIT-COST tools, respectively. Multivariable linear regression models estimated the associations of patient characteristics with HRQoL and FT and the effect of FT on HRQoL. Most women experienced FT. After multivariable adjustments, unemployed women, women with ovarian and uterine cancers and choriocarcinoma, higher disease stages, and worse ECOG status had worse HRQoL. Conversely, women in remission had better HRQoL. FT was worse with stages III and IV disease and in those on active treatment. However, older women, those with health insurance, higher income, ovarian cancer and choriocarcinoma had better FT. FT varied linearly with HRQoL, with better HRQoL per unit better FT. This effect was stronger in those with a first tumor, those in pre-treatment and those in remission. Our findings identify possible predictors of HRQoL and FT and suggest potential benefits of reducing FT on the HRQoL of women with gynecological cancers in Nigeria.https://doi.org/10.1038/s41598-025-13763-0Quality of lifeFinancial toxicityGynecological cancerNigeria
spellingShingle Chibuzor F. Ogamba
Adedayo Joseph
Ayodeji Kayode Adefemi
Chidike Onyedikachi Ezegwui
Ajay Major
Rasaq Oluwagbemiga Jimoh
Michael Osahumen Orhue
Michael Chudi Ezeanochie
Boniface Uji Ago
Linda Ogochukwu Amah
Emeka Emmanuel Okoh
Courage Osamudiamen Idahor
Mazpa Ejikem
Alexander Clive Tinworth
Charilaos Zisou
Nwamaka N. Lasebikan
Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern Nigeria
Scientific Reports
Quality of life
Financial toxicity
Gynecological cancer
Nigeria
title Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern Nigeria
title_full Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern Nigeria
title_fullStr Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern Nigeria
title_full_unstemmed Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern Nigeria
title_short Factors associated with health-related quality of life and financial toxicity among gynecological cancer patients in Southern Nigeria
title_sort factors associated with health related quality of life and financial toxicity among gynecological cancer patients in southern nigeria
topic Quality of life
Financial toxicity
Gynecological cancer
Nigeria
url https://doi.org/10.1038/s41598-025-13763-0
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