Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2017; 38(03): 277-281
DOI: 10.4103/ijmpo.ijmpo_15_16
Original Article

Sociodemographic Factors and Late‑stage Diagnosis of Breast Cancer in India: A Hospital‑based Study

Jignasa Amrutlal Sathwara
Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Ganesh Balasubramaniam
Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Saurabh C Bobdey
Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Aanchal Jain
Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Sushama Saoba
Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Context: Breast cancer (BC) is one of the major causes of cancer mortality in India. Late-stage diagnosis of BC is associated with poor survival. Identification of factors affecting late presentation of the disease could be an effective step to reduce BC mortality. Aims: To study the association of sociodemographic factors with BC stage at diagnosis. Settings and Design: The study is a retrospective analysis from the case records from a single institution. Subjects and Methods: Data for the year 2008 was collected from the hospital records. A total of 1210 cases were included for the analysis. Sociodemographic factors included were age, place of residence, religion, marital status, level of education, and occupation. Other study variables were family history, presence of comorbidity, and stage at diagnosis. Statistical Analysis: Association between sociodemographic factors by stage at diagnosis was tested using Chi-square statistics, with odds ratios (ORs) estimated through logistic regression modeling. Results: In the study cohort, 46% patients had reported at early stages and 54% at advanced stages. All factors were evaluated for being predictors of disease stage at presentation using univariate and multivariate logistic regression model. Women from urban background were less likely to present with advanced stage disease (OR = 0.64; 95% confidence interval [CI]: 0.49–0.84) as compared to rural women. Similarly, illiterate women were also more likely to present with advanced-stage disease (OR = 1.55; 95% CI: 1.16–2.09). Conclusions: This data clearly indicate that the patients of rural background and of low education status are more likely than their respective counterparts to have an advanced stage of BC diagnosis. Our results may be considered the keys to determining how stage variation may be related to patients and community characteristics and where limited resources need to be invested to ensure early diagnosis of BC.

Keywords

Breast cancer - sociodemographic factors - stage


Publication History

Article published online:
04 July 2021

© 2017. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://www.globocan.iarc.fr. [Last accessed on 2016 Jan 24].
  • 2 Rajaraman P, Anderson BO, Basu P, Belinson JL, Cruz AD, Dhillon PK, et al. Recommendations for screening and early detection of common cancers in India. Lancet Oncol 2015;16:e352-61.
  • 3 Nagrani RT, Budukh A, Koyande S, Panse NS, Mhatre SS, Badwe R, et al. Rural urban differences in breast cancer in India. Indian J Cancer 2014;51:277-81.
  • 4 Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer Incidence in Five Continents. IARC Scientific Publications No. 160. Vol. IX. Lyon, France: IARC; 2007.
  • 5 Agarwal G, Ramakant P. Breast cancer care in India: The current scenario and the challenges for the future. Breast Care (Basel) 2008;3:21-7.
  • 6 Kaffashian F, Godward S, Davies T, Solomon L, McCann J, Duffy SW, et al. Socioeconomic effects on breast cancer survival: Proportion attributable to stage and morphology. Br J Cancer 2003;89:1693-6.
  • 7 Stavraky KM, Skillings JR, Stitt LW, Gwadry-Sridhar F. The effect of socioeconomic status on the long-term outcome of cancer. J Clin Epidemiol 1996;49:1155-60.
  • 8 Dalton SO, Ross L, Düring M, Carlsen K, Mortensen PB, Lynch J, et al. Influence of socioeconomic factors on survival after breast cancer – A nationwide cohort study of women diagnosed with breast cancer in Denmark 1983-1999. Int J Cancer 2007;121:2524-31.
  • 9 Ali R, Mathew A, Rajan B. Effects of socio-economic and demographic factors in delayed reporting and late-stage presentation among patients with breast cancer in a major cancer hospital in South India. Asian Pac J Cancer Prev 2008;9:703-7.
  • 10 Yabroff KR, Gordis L. Does stage at diagnosis influence the observed relationship between socioeconomic status and breast cancer incidence, case-fatality, and mortality? Soc Sci Med 2003;57:2265-79.
  • 11 American Cancer Society. Breast Cancer Survival Rates by Stage. Available from: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-survival-by-stage. [Last accessed on 2016 Jan 12].
  • 12 Hanrahan EO, Gonzalez-Angulo AM, Giordano SH, Rouzier R, Broglio KR, Hortobagyi GN, et al. Overall survival and cause-specific mortality of patients with stage T1a, bN0M0 breast carcinoma. J Clin Oncol 2007;25:4952-60.
  • 13 Herndon JE 2nd, Kornblith AB, Holland JC, Paskett ED. Effect of socioeconomic status as measured by education level on survival in breast cancer clinical trials. Psychooncology 2013;22:315-23.
  • 14 Hunter CP. Epidemiology, stage at diagnosis, and tumor biology of breast carcinoma in multiracial and multiethnic populations. Cancer 2000;88:1193-202.
  • 15 Memon ZA, Shaikh AN, Rizwan S, Sardar MB. Reasons for patient's delay in diagnosis of breast carcinoma in Pakistan. Asian Pac J Cancer Prev 2013;14:7409-14.
  • 16 Miller AB. Mammography: A critical evaluation of its role in breast cancer screening, especially in developing countries. J Public Health Policy 1989;10:486-98.
  • 17 Babu GR, Lakshmi SB, Thiyagarajan JA. Epidemiological correlates of breast cancer in south India. Asian Pac J Cancer Prev 2013;14:5077-83.
  • 18 MacKinnon JA, Duncan RC, Huang Y, Lee DJ, Fleming LE, Voti L, et al. Detecting an association between socioeconomic status and late stage breast cancer using spatial analysis and area-based measures. Cancer Epidemiol Biomarkers Prev 2007;16:756-62.
  • 19 Sharma K, Costas A, Shulman LN, Meara JG. A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. J Oncol 2012;2012:121873.
  • 20 Harirchi I, Ghaemmaghami F, Karbakhsh M, Moghimi R, Mazaherie H. Patient delay in women presenting with advanced breast cancer: An Iranian study. Public Health 2005;119:885-91.
  • 21 Leong SP, Shen ZZ, Liu TJ, Agarwal G, Tajima T, Paik NS, et al. Is breast cancer the same disease in Asian and western countries? World J Surg 2010;34:2308-24.
  • 22 Gadgil A, Roy N, Sankaranarayanan R, Muwonge R, Sauvaget C. Effect of comprehensive breast care on breast cancer outcomes: A community hospital based study from Mumbai, India. Asian Pac J Cancer Prev 2012;13:1105-9.
  • 23 Miller BA, Hankey BF, Thomas TL. Impact of sociodemographic factors, hormone receptor status, and tumor grade on ethnic differences in tumor stage and size for breast cancer in US women. Am J Epidemiol 2002;155:534-45.
  • 24 Mohaghegh P, Yavari P, Akbari ME, Abadi A, Ahmadi F. Associations of demographic and socioeconomic factors with stage at diagnosis of breast cancer. Asian Pac J Cancer Prev 2015;16:1627-31.
  • 25 Richardson JL, Langholz B, Bernstein L, Burciaga C, Danley K, Ross RK, et al. Stage and delay in breast cancer diagnosis by race, socioeconomic status, age and year. Br J Cancer 1992;65:922-6.
  • 26 Satariano WA, Ragland DR. The effect of comorbidity on 3-year survival of women with primary breast cancer. Ann Intern Med 1994;120:104-10.
  • 27 Neal RD, Allgar VL. Sociodemographic factors and delays in the diagnosis of six cancers: Analysis of data from the “National survey of NHS patients: Cancer”. Br J Cancer 2005;92:1971-5.
  • 28 Meechan G, Collins J, Petrie K. Delay in seeking medical care for self-detected breast symptoms in New Zealand women. N Z Med J 2002;115:U257.
  • 29 Ramirez AJ, Westcombe AM, Burgess CC, Sutton S, Littlejohns P, Richards MA, et al. Factors predicting delayed presentation of symptomatic breast cancer: A systematic review. Lancet 1999;353:1127-31.
  • 30 Burgess CC, Ramirez AJ, Richards MA, Love SB. Who and what influences delayed presentation in breast cancer? Br J Cancer 1998;77:1343-8.
  • 31 Meechan G, Collins J, Petrie KJ. The relationship of symptoms and psychological factors to delay in seeking medical care for breast symptoms. Prev Med 2003;36:374-8.
  • 32 Yip CH, bt Mohd Taib NA, Lau PC. Does a positive family history influence the presentation of breast cancer? Asian Pac J Cancer Prev 2008;9:63-5.