Social Determinants Associated With the Advanced-Stage Diagnosis of Breast Cancer.

Abstract

Purpose: The majority of Egyptian patients with breast cancer (BC) present at advanced stages. We examined the sociodemographic and clinical factors associated with late presentation of BC.

Methods: A retrospective cohort study was conducted on patients who presented with BC between 2011 and 2020. Logistic regression analysis was used to examine the association between sociodemographic factors and advanced-stage BC.

Results: This cohort included 1,953 patients with a median age of 52 years. Among them, 1,098 (56.2%) patients were diagnosed at early stages, whereas 855 (43.8%) were diagnosed at advanced stages. Univariable logistic regression revealed several factors associated with advanced BC, including having a negative family history of BC (odds ratio [OR], 1.27 [95% CI, 1.05 to 1.54]), having no job (OR, 1.28 [95% CI, 1.06 to 1.53]), being married (OR, 1.27 [95% CI, 1.02 to 1.57]), rural residence (OR, 1.27 [95% CI, 1.02 to 1.57]), having more than three children (OR, 1.42 [95% CI, 1.15 to 1.75]), higher Ki67% score (OR, 1.01 [95% CI, 1.00 to 1.01]), having human epidermal growth factor receptor 2-overexpressed or triple-negative BC subtypes (OR, 1.44 [95% CI, 1.16 to 1.79]), and having tumor grade 2/3 (OR, 4.12 [95% CI, 1.58 to 10.77 and OR, 1.44 [95% CI, 1.16 to 1.79], respectively). In the multivariable logistic regression model, only higher Ki67% (adjusted odds ratio [aOR], 1.01 [95% CI, 1.00 to 1.02]), having no job (aOR, 1.44 [95% CI, 1.10 to 1.90]), and rural residence (aOR, 1.88 [95% CI, 1.03 to 3.42]) were significantly associated with advanced BC.

Conclusion: This study concluded that having no job and rural residence are strongly associated with advanced BC. Raising public awareness is essential to encourage early detection of BC.