{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:34:44Z","timestamp":1786700084225,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Roche Real-World Data\/Evidence (RWD\/E) Award 2023"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Background\/Objectives: In Lebanon, the economic crisis since 2019 has severely strained healthcare infrastructure, yet its impact on cancer treatment adherence remains incompletely characterized. This study assessed factors associated with treatment delay and regimen modification to identify barriers to optimal cancer care among Lebanese patients. Methods: This multicenter, cross-sectional study was conducted in five tertiary hospitals in Beirut, Lebanon, between 13 June 2024, and 27 June 2025. Demographic, clinical and treatment data were collected via a structured questionnaire. Bivariate and multivariable binary logistic regression analyses were performed to identify independent predictors of treatment delay (&gt;2 weeks) and incomplete treatment regimens. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) are reported. Results: A total of 244 patients were enrolled in the study. The study population was predominantly female (59.0%) and aged \u226560 years (60.2%). Advanced disease was common, with 50.4% of patients presenting with stage IV disease. Financial vulnerability was widespread: 72.6% reported monthly household incomes below USD 1000, 88.1% reported a decline in income due to the economic crisis, and 39.3% relied on unstable income sources. Overall, 52.5% of patients experienced treatment initiation delays, and 9.0% received incomplete or dose-reduced regimens. On multivariable analysis, reliance on unfixed income independently predicted treatment delay (aOR 2.55, 95% CI 1.42\u20134.59; p = 0.002), lack of health insurance (aOR 1.91, 95% CI 1.08\u20133.39; p = 0.026) and pre-treatment surgical costs also increased the odds of delay (aOR 9.03, 95% CI 2.57\u201331.7; p = 0.001). For incomplete treatment, unfixed income remained an independent predictor (aOR 2.09, 95% CI 1.16\u20135.79; p = 0.015). A lack of insurance (aOR 5.62, 95% CI 1.22\u201325.9; p = 0.027) and high laboratory costs (&gt;USD 150 per session) were also associated with incomplete regimens (aOR 1.62, 95% CI 1.02\u20132.57; p = 0.041). Conclusions: In Lebanon\u2019s crisis context, financial instability was a key factor associated with deviations in cancer treatment. These findings highlight the need for strengthened insurance coverage and subsidization of diagnostic and treatment-related costs to ensure timely and continuous oncologic care.<\/jats:p>","DOI":"10.3390\/curroncol33080478","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T08:08:29Z","timestamp":1786694909000},"page":"478","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Lebanon\u2019s Economic Crisis on Cancer Care Delivery: A Multicenter Cross-Sectional Study of Treatment Initiation Delays and Incomplete Therapy"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3928-6161","authenticated-orcid":false,"given":"Mohamad Ali","family":"Hachem","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"},{"name":"International Department, Gustave Roussy Cancer Campus, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1984-7148","authenticated-orcid":false,"given":"Nadeen","family":"Zayour","sequence":"additional","affiliation":[{"name":"Organized Research Unit, Al Zahraa Hospital University Medical Center, Beirut P.O. Box 90-361, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4656-9373","authenticated-orcid":false,"given":"Elie","family":"Daibess","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"},{"name":"International Department, Gustave Roussy Cancer Campus, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Najjar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3137-1128","authenticated-orcid":false,"given":"Elie Jean","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solay","family":"Farhat","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2683-8229","authenticated-orcid":false,"given":"Zeinab","family":"Hammoud","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5642-9017","authenticated-orcid":false,"given":"Ghadir M.","family":"Nasreddine","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Abbass","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinab","family":"Sleiman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maroun","family":"Sadek","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Lebanese Hospital Geitaoui-University Medical Center, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Makassed General Hospital, Beirut P.O. Box 11-6301, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issam","family":"Chehade","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Rafik Hariri Hospital, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-9358","authenticated-orcid":false,"given":"Bassam","family":"Matar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medical Sciences, Lebanese University, Beirut P.O. Box 14-6573, Lebanon"},{"name":"Department of Hematology and Oncology, Al Zahraa Hospital University Medical Center, Beirut P.O. Box 90-361, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA-Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"10732748251408880","DOI":"10.1177\/10732748251408880","article-title":"Cancer in the oldest-old population in the MENA region: Epidemiology and temporal trends based on GBD 2021","volume":"32","author":"Lakkis","year":"2025","journal-title":"Cancer Control"},{"key":"ref_3","unstructured":"International Agency for Research on Cancer (2026, February 27). GLOBOCAN 2022: Lebanon Cancer Fact Sheet. 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