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.

ABSTRACT

OBJECTIVE: We analyzed the distribution of socio-economic and demographic (SEDs) factors among breast cancer patients and assessed their impact on the stage at diagnosis of the disease and symptom duration. METHODS: Data for the year 2006 was collected from the Hospital Based Cancer Registry, Regional Cancer Centre (RCC), Trivandrum, Kerala, India. Patients (n=522) were included if they were from native Kerala state or adjoining Tamil Nadu. SEDS factors included age, residing district, religion, marital status, income, education and occupation. Other study variables were menopausal status, parity, listed symptoms with duration and stage at diagnosis. Association between SEDs factors by stage at diagnosis and duration of symptoms was tested using chi-square statistics, with odds ratios (OR) estimated through logistic regression modeling. RESULTS: Forty-five percent were reported at early stages and 53% at late stages. Elevated risks for late stage reporting among breast cancer patients were observed for women who were unmarried (OR=3.31; 95%CI 1.10-9.96), widowed/divorced (OR=1.46; 95%CI 0.89-2.37), with lower education (OR=2.72; 95%CI 1.06-7.03 for illiterate women and OR=2.32; 95%CI 1.05-5.13 for women with primary school education and OR=2.07; 95%CI 1.02-4.21 for women with middle school education) and post-menopausal women (OR=1.45; 95%CI 0.97-2.19). CONCLUSIONS: This analysis helped to identify the target population group for receiving health education for early detection of breast cancer.