Experiences of accessing and using breast cancer services in Vietnam: a descriptive qualitative study

Jenkins, Chris; Ngan, Tran Thu; Nguyen, Ngoc Binh; Ho, Hien Thi; Anh, Nguyễn Hoàng; Lohfeld, Lynne; Donnelly, Michael; Minh, Hoàng Văn; Murray, Liam

doi:10.1136/bmjopen-2019-035173

Cited by 21 publications

(33 citation statements)

References 24 publications

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“…As noted by one BC patient, 'People with money think about dying because of the disease. People without money think about dying because of not having money' [2]. The patient-level impact of the cost of cancer care has been referred to as 'financial toxicity' which is consequence of both objective financial burden and subjective financial distress [3,4].…”

Section: Introductionmentioning

confidence: 99%

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Ngan

Minh

Donnelly

et al. 2021

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Background This study examined the financial toxicity faced by breast cancer (BC) patients in Vietnam and the factors associated with the risk and degree of that toxicity. Methods A total of 309 BC patients/survivors completed an online survey (n=209) or a face-to-face interview (n=100) at two tertiary hospitals. Descriptive statistics and χ2 tests were used to identify and analyse the forms and degree of financial toxicity faced by BC patients/survivors. A Cragg hurdle model assessed variation in risk and the degree of financial toxicity due to treatment. Results 41% of respondents faced financial toxicity due to BC treatment costs. The mean amount of money that exceeded BC patients/survivors’ ability to pay was 153 million Vietnamese Dong (VND) ($6602) and ranged from 2.42 million VND to 1358 million VND ($104–58,413). A diagnosis at stage II or III of BC was associated with 16.0 and 18.0 million VND (~$690–777) more in the degree of financial toxicity compared with patients who were diagnosed at stage 0/I, respectively. Being retired or married or having full (100%) health insurance was associated with a decrease in the degree of financial toxicity. Conclusions A significant proportion of Vietnamese BC patients/survivors face serious financial toxicity due to BC treatment costs. There is a need to consider the introduction of measures that would attenuate this hardship and promote uptake of screening for the reduction in financial toxicity as well as the health gains it may achieve through earlier detection of cancer.

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Section: Introductionmentioning

confidence: 99%

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Ngan

Minh

Donnelly

et al. 2021

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“…The maximum value with and without outliers was 824 million VND ($35,554) and 17 million VND ($734), respectively. The outliers likely re ect patients having to go through multiple tests at different hospitals before reaching the de nitive diagnosis of BC [13].…”

Section: Discussionmentioning

confidence: 99%

“…ne needle aspiration-FNA, core needle biopsy, vacuum-assisted breast biopsy-VABB) [9]. Patients may use these services several times at different hospitals before starting the treatment [13]. Therefore, respondents reported the lump sum of all health services related to diagnosis that they received rather than the cost of each individual service.…”

Section: Cost Of Diagnosismentioning

confidence: 99%

Costs of Breast Cancer Treatment Incurred by Women in Vietnam

Ngan

Nguyen

Minh

et al. 2021

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Background: There is a paucity of research on the cost of breast cancer (BC) treatment from the patient’s perspective in Vietnam.Methods: Individual-level data about out-of-pocket (OOP) expenditures on use of services were collected from women treated for BC (n=202) using an online survey and a face-to-face interview at two tertiary hospitals in 2019. Total expenditures on diagnosis and initial BC treatment were presented in terms of the mean, standard deviation, and range for each type of service use. A generalised linear model (GLM) was used to assess the relationship between total cost and socio-demographic characteristics.Results: 19.3% of respondents had stage 0/I BC, 68.8% had stage II, 9.4% had stage III, none had stage IV. The most expensive OOP elements were targeted therapy with mean cost equal to 649.5 million VND ($28,025) and chemotherapy at 36.5 million VND ($1,575). Mean total OOP cost related to diagnosis and initial BC treatment (excluding targeted therapy cost) was 61.8 million VND ($2,667). The mean OOP costs among patients with stage II and III BC were, respectively, 66% and 148% higher than stage I.Conclusions: BC patients in Vietnam incur significant OOP costs. The cost of BC treatment was driven by use of therapies and presentation stage at diagnosis. It is likely that OOP costs of BC patients would be reduced by earlier detection through raised awareness and screening programs and by providing a higher insurance coverage rate for targeted therapy.

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“…A question raised by this media content analysis concerns the disconnection between information shared in the media regarding breast cancer risk factors, symptoms and expectations for treatment, and reported knowledge by women in other studies. Despite the largely factual and accurate reporting about breast cancer in the mass media, knowledge and awareness about breast cancer is generally poor [4,[28][29][30]. This raises questions about the medium, focus, and delivery of content.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer messaging in Vietnam: an online media content analysis

Jenkins

Lan³

et al. 2020

BMC Public Health

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Background: Breast cancer incidence is increasing in Vietnam with studies indicating low levels of knowledge and awareness and late presentation. While there is a growing body of literature on challenges faced by women in accessing breast cancer services, and for delivering care, no studies have sought to analyse breast cancer messaging in the Vietnamese popular media. The aim of this study was to investigate and understand the content of messages concerning breast cancer in online Vietnamese newspapers in order to inform future health promotional content. Methods: This study describes a mixed-methods media content analysis that counted and ranked frequencies for media content (article text, themes and images) related to breast cancer in six Vietnamese online news publications over a twelve month period. Results: Media content (n = 129 articles & n = 237 images) sampled showed that although information is largely accurate, there is a marked lack of stories about Vietnamese women's personal experiences. Such stories could help bridge the gap between what information about breast cancer is presented in the Vietnamese media, and what women in Vietnam understand about breast cancer risk factors, symptoms, screening and treatment. Conclusions: Given findings from other studies indicating low levels of knowledge and women with breast cancer experiencing stigma and prejudice, more nuanced and in-depth narrative-focused messaging may be required.

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Experiences of accessing and using breast cancer services in Vietnam: a descriptive qualitative study

Cited by 21 publications

References 24 publications

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Costs of Breast Cancer Treatment Incurred by Women in Vietnam

Breast Cancer messaging in Vietnam: an online media content analysis

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