Patient experience with cancer care before and after the war in Ukraine — Abstract

Background: The war in Ukraine has resulted in decreased access to cancer care. We explored factors associated with care receipt and delays before and after the war.

Methods: An online survey was disseminated through social media focused on cancer patients in Ukraine in April 2023. The pre-specified analysis utilized descriptive statistics and standard tests of association.

Results: Of 289, 73% were female, from all 24 regions, including:

Of 289, 73% were female, from all 24 regions, including 87 (30%) Kyiv, 76 (26%) west, 38 (18%) central, 39 (13%) south, 36 (12%) northeast. 185 (65%) finished college, 76 (26%) technical school, 26 (9%) high school. 143 (49%) were diagnosed with cancer during the war (2022-2023).

143 (49%) were diagnosed with cancer during the war (2022-2023).

112 (39%) had Stage I-II, 80 (38%) Stage III, and 79 (28%) Stage IV, including 99 (34%) breast, 27 (9%) colorectal, 20 (7%) lymphoma, 15 (5%) head/neck, 13 (4%) cervix, 12 lung.

with no change before and after war and no effect on care wait times > 2 months.

Total OOP treatment types was associated with number of treatment wait times > 2 months (p = 0.02).

24 (8%) moved within Ukraine and 46 (16%) abroad due to war.

Participants from the war-affected south and northeastern Ukraine were less likely to continue cancer care at home 36 (49%) v 147 (71%) (p=0.001), and less likely to move abroad for treatment 21 (15%) v 35 (26%) (p = 0.04).

Cancer diagnosis after the war not associated with reported diagnosis delays or wait times of > 2 months. Moving and region were not associated with increased diagnosis or specific treatment wait times.

The total number of treatment wait times > 2 months was higher in southern and northeast Ukraine (p = 0.05).

Wait times > 2 months for radiation were less likely in central Ukraine 4 (19%) v 49 (47%) (p= 0.03) and less likely for surgery (8%) v 17 (31%) (p = 0.03) and chemotherapy (1/26) 3.8% v (16/79) 20% (p = 0.06) in Kyiv.

Patients with cervical were more likely (6 (54%) v 36 (18%) (p = 0.01)) and those with breast cancer less likely 8 (10%) v 34 (23%) (p = 0.02) to wait for > 2 months for chemotherapy.

Conclusion: Survey participants were highly educated; a large proportion paid OOP for treatment; almost half in war-affected regions moved away. Though overall access to and quality of care remained similar, total treatment wait times were higher in war-torn regions, while timely access to radiation and chemotherapy was better in regions less affected by war and refugee influx.