Cost of breast cancer care in low and middle-income countries: a scoping review protocol

bjective: This review will describe the scope of the literature on the cost of breast cancer care in low and middle income countries (LMICs), summarize estimated costsof breast cancer diagnosis andtreatment, and assess the methodologies used to calculate cost. Introduction: In the past decade, there has been global momentum to improve capacity for breast cancer care in LMICs, which have higher rates of breast cancer mortality compared to high income countries. Understanding the cost of delivering breast cancer care in LMICs is critical to guide effective cancer care delivery strategies and policy.Inclusion criteria:Studies that estimate the cost of breast cancer diagnosis andtreatment in LMICs will be included. Studies not available in English will be excluded.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses -Scoping Review guidelines will be utilized. The search strategy has been developed in consultation with a medical librarian and will be performed in five electronic databases from their inception (MEDLINE, Embase, Web of Science, Global Health, WHO Global Index Medicus) as well as ingray literature. Two independent reviewers will review all abstracts and titles in the primary screen and full-text articles in the secondary screen. A third reviewer will adjudicate conflicts. One reviewer will perform data extraction. Study characteristics and cost estimates will be summarized in narrative and tabular formats. The methodological quality of studies will be evaluated using a validated economic evaluation tool as well as a ranking system that denotes the comprehensiveness of cost analysis inputs