Sathwara Jignasa Amrutlal, Balasubramaniam Ganesh, Bobdey Saurabh C, Jain Aanchal, Saoba Sushama
Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Indian J Med Paediatr Oncol. 2017 Jul-Sep;38(3):277-281. doi: 10.4103/ijmpo.ijmpo_15_16.
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.
To study the association of sociodemographic factors with BC stage at diagnosis.
The study is a retrospective analysis from the case records from a single institution.
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.
Association between sociodemographic factors by stage at diagnosis was tested using Chi-square statistics, with odds ratios (ORs) estimated through logistic regression modeling.
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).
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.
乳腺癌（BC）是印度癌症死亡的主要原因之一。BC的晚期诊断与生存率低相关。识别影响该疾病晚期就诊的因素可能是降低BC死亡率的有效措施。
研究社会人口学因素与诊断时BC分期的相关性。
本研究是对单个机构病例记录的回顾性分析。
收集了2008年医院记录中的数据。共纳入1210例病例进行分析。纳入的社会人口学因素包括年龄、居住地点、宗教、婚姻状况、教育程度和职业。其他研究变量为家族史、合并症情况及诊断时的分期。
使用卡方统计检验诊断时社会人口学因素与分期之间的相关性，并通过逻辑回归模型估计比值比（OR）。
在研究队列中，46%的患者在早期就诊，54%在晚期就诊。使用单因素和多因素逻辑回归模型评估所有因素作为就诊时疾病分期预测因素的情况。与农村女性相比，城市背景的女性患晚期疾病的可能性较小（OR = 0.64；95%置信区间[CI]：0.49 - 0.84）。同样，文盲女性也更有可能患晚期疾病（OR = 1.55；95% CI：1.16 - 2.09）。
这些数据清楚地表明，农村背景和低教育水平的患者比各自的对应人群更有可能被诊断为晚期BC。我们的结果可被视为确定分期差异如何与患者及社区特征相关以及需要在何处投入有限资源以确保BC早期诊断的关键。
