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

Abstract

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. 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. 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. 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.