Assessment of financial toxicity among patients treated for cervical cancer in Rwanda, a cross-sectional study

Cervical cancer remains a major public health challenge mainly in low- and middle-income countries, including Rwanda, where most patients present at advanced stages and face significant treatment-related expenses. Despite the presence of national health insurance schemes, many patients continue to experience financial distress associated with cancer care. This study assessed the proportion and determinants of financial toxicity (FT) among cervical cancer patients receiving treatment at the Rwanda Cancer Center (RCC). A cross-sectional study conducted among patients with cervical cancer under active treatment or follow-up at the Rwanda cancer center of the Rwanda Military from October 2022 until October 2023, convenience sampling were employed to interview recruited participants until the target number. Among 221 enrolled participants, 25.8% met criterial for financial toxicity.Predicators of FT included Ubudehe category 2,farming as primary occupation, lack of sufficient income for medicineor transportationand patients with not enough income for food and housing costs. FT is prevalent among cervical cancer in Rwanda especially in those with preexisting insufficient household income and those who engaged in farming, even among insured patients. Given the direct consequence of financial constraints on cervical cancer care, it is urgent to address financial hardships cancer patients face withsystemic reforms in health financing, decentralization of cancer care, and social protection interventions such as transport subsidies and conditional cash support might improve adherence, treatment outcomes, and equity in cancer care.