The social determinants associated with the advanced stage diagnosis of breast cancer in Egypt in the previous ten years: a single-center quantitative retrospective cohort study
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1
Centre for Public Health, Wolfson Institute of Population Health, Queen Mary University of London, United Kingdom
2
Clinical Oncology Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
3
Cairo Oncology Center, Egypt
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A842
ABSTRACT
Background: Breast cancer (BC) is the most common cancer among women worldwide. Most BC patients are diagnosed late in Egypt. This study aims to observe the socio-demographic inequalities associated with the advanced stage diagnosis of BC in Egypt in the previous ten years. Methods: This is a retrospective cohort study of patients with BC who presented to Cairo Oncology Center between 2011 and 2020. Results: This cohort included 1953 patients. Logistic regression analyses revealed that most socio-demographic factors affected the stage of BC diagnosis. Single patients had 21% lower odds of being diagnosed at advanced stages than married ones (odds ratio [OR]=0.79; 95% CI 0.638 – 0.979, p=0.031). Unemployed patients had 27.5% higher odds of getting diagnosed late than employed ones (OR=1.275; 95% CI 1.062 – 1.531, p=0.009). Patients who live in rural areas were 89.1% more likely to present with advanced disease than those who live in urban areas (OR=1.891; 95% CI 1.314 – 2.722, p=0.001). Patients with three children or less had 29.3% lower odds of presenting with advanced disease than those with more than three children (OR=0.707; 95% CI 0.572 – 0.873, p=0.001). In contrast, there was no significant difference in odds of presenting with advanced BC between males and females and between Muslims and Christians (OR=1.936; 95% CI 0.686 – 5.641, p=0.212, OR=1.180; 95% CI 0.804 – 1.732, p=0.399, respectively). There was no difference in the mean age at diagnosis between advanced and early disease patients (52.3 vs. 51.233, p=0.057). Conclusions: This 10-year single-center study highlights the socio-demographic disparities among BC patients. The study concluded that marital status, employment status, residence, and the number of children are highly associated with the stage of BC diagnosis. In contrast, religion, gender, and age at diagnosis are not associated with the stage of BC diagnosis.