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  • The economic burden of cancer care for Syrian refugees: a population-based modelling study

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    Author(s)
    Abdul-Khalek, Rima A
    Guo, Ping
    Sharp, Forbes
    Gheorghe, Adrian
    Shamieh, Omar
    Kutluk, Tezer
    Fouad, Fouad
    Coutts, Adam
    Aggarwal, Ajay
    Mukherji, Deborah
    Abu-Sittah, Ghassan
    Chalkidou, Kalipso
    Sullivan, Richard
    Griffith University Author(s)
    Chalkidou, Kalipso
    Year published
    2020
    Metadata
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    Abstract
    BACKGROUND: Cancer represents a substantial health burden for refugees and host countries. However, no reliable data on the costs of cancer care for refugees are available, which limits the planning of official development assistance in humanitarian settings. We aimed to model the direct costs of cancer care among Syrian refugee populations residing in Jordan, Lebanon, and Turkey. METHODS: In this population-based modelling study, direct cost per capita and per incident case for cancer care were estimated using generalised linear models, informed by a representative dataset of cancer costs drawn from 27 EU countries. A range ...
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    BACKGROUND: Cancer represents a substantial health burden for refugees and host countries. However, no reliable data on the costs of cancer care for refugees are available, which limits the planning of official development assistance in humanitarian settings. We aimed to model the direct costs of cancer care among Syrian refugee populations residing in Jordan, Lebanon, and Turkey. METHODS: In this population-based modelling study, direct cost per capita and per incident case for cancer care were estimated using generalised linear models, informed by a representative dataset of cancer costs drawn from 27 EU countries. A range of regression specifications were tested, in which cancer costs were modelled using different independent variables: gross domestic product (GDP) per capita, crude or age-standardised incidence, crude or age-standardised mortality, and total host country population size. Models were compared using the Akaike information criterion. Total cancer care costs for Syrian refugees in Jordan, Lebanon, and Turkey were calculated by multiplying the estimated direct cancer care costs (per capita) by the total number of Syrian refugees, or by multiplying the estimated direct cancer costs (per incident case [crude or age-standardised]) by the number of incident cancer cases in Syrian refugee populations. All costs are expressed in 2017 euros (€). FINDINGS: Total cancer care costs for all 4·74 million Syrian refugees in Jordan, Lebanon, and Turkey in 2017 were estimated to be €140·23 million using the cost per capita approach, €79·02 million using the age-standardised incidence approach, and €33·68 million using the crude incidence approach. Under the lowest estimation, and with GDP and total country population as model predictors, the financial burden of cancer care was highest for Turkey (€25·18 million), followed by Lebanon (€6·40 million), and then Jordan (€2·09 million). INTERPRETATION: Cancer among the Syrian refugee population represents a substantial financial burden for host countries and humanitarian agencies, such as the UN Refugee Agency. New ways to provide financial assistance need to be found and must be coupled with clear, prioritised pathways and models of care for refugees with cancer. FUNDING: UK Research and Innovation Global Challenges Research Fund: Research for Health in Conflict-Middle East and North Africa region (R4HC-MENA).
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    Journal Title
    Lancet Oncology
    Volume
    21
    Issue
    5
    DOI
    https://doi.org/10.1016/S1470-2045(20)30067-X
    Copyright Statement
    © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Subject
    Oncology and Carcinogenesis
    Science & Technology
    Life Sciences & Biomedicine
    COLORECTAL-CANCER
    EUROPEAN-UNION
    Publication URI
    http://hdl.handle.net/10072/397682
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    • Journal articles

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