Catastrophic health expenditures for colorectal cancer care: A retrospective analysis of the first private comprehensive cancer center in Lagos, Nigeria

Nearly a billion people worldwide risk Financial Catastrophe (FC) due to Out-of-Pocket (OOP) health expenditures. With Low-and-Middle-Income Countries (LMICs) disproportionately impacted, and the global burden of colorectal cancer (CRC) expected to increase 60 ​% by 2030, Nigeria is of interest. This study aims to evaluate the cost of treating CRC at Nigeria's first private cancer center. The center's cancer registry was queried for CRC diagnosed between 2013 and 2023. Two research assistants in Lagos abstracted treatment costs (adjusted to 2023 USD), demographics and clinical characteristics. FC was defined as OOP >20 ​% of Nigeria's 2023 per-capita GDP ($467). 92 patients (colon (n ​= ​70), rectum (n ​= ​22), 66 ​% stage 4) were included. Average chemotherapy cost $7,678, procedure cost $1157. Average total cost for multi-therapy, $34,983. All treated patients risked FC. The greatest cost-contributors were chemotherapy (30 ​%) and other drugs (21 ​%). Procedures cost 3 ​%. CRC treatment increases the risk of FC for nearly all patients. Risk-protection through insurance or financial navigation may be of benefit, and future studies should investigate the impact of these interventions on FC risk. •Colorectal cancer care puts most Nigerian patients at risk for financial catastrophe.•High cost may preclude patients from receiving necessary cancer care.•Measures that mitigate the risk of financial catastrophe in Nigerian CRC patients require further investigation.