The social determinants associated with the advanced stage diagnosis of breast cancer in Egypt

Background Majority of Egyptian breast cancer (BC) patients present at advanced stages. We examined the sociodemographic and clinical factors associated with late presentation of BC. Methods This is a retrospective cohort study of patients who presented with BC between 2011 and 2020. Logistic regression was performed to examine the association between sociodemographic factors and advanced BC. Results This cohort included 1,953 patients with median age of 52 years. 1,098 (56.2%) patients were diagnosed at early stages, while 855 (43.8%) patients were diagnosed at advanced stages. Univariate logistic regression analyses revealed that several sociodemographic and clinical factors were associated with advanced BC, including having negative family history of BC (OR= 0.1.27; 95% CI:1.05 – 1.54), having no job (OR= 1.28; 95% CI: 1.06 – 1.53), being married (OR=1.27; 95% CI:1.02 – 1.57), rural residence (OR=1.27; 95% CI:1.02 – 1.57), having more than three children (OR=1.42; 95% CI:1.15 – 1.75), higher KI-67% score (OR=1.01; 95% CI:1.00 - 1.01), having HER2-Enriched or TNBC subtypes (OR= 1.44; 95% CI:1.16 – 1.79), and having tumor grate II/III (OR=4.12; 95% CI:1.58 – 10.77 & OR= 1.44; 95% CI:1.16 – 1.79, respectively). In the multivariate logistic regression model, only KI-67% (aOR=1.01; 95% CI:1.00 - 1.02), having no job (aOR=1.44; 95% CI:1.10 – 1.90), and rural residence (aOR=1.88; 95% CI:1.03 – 3.42) were significantly associated with advanced BC. Conclusion This study concluded that having no job and rural residence are highly associated with advanced BC. Raising the public awareness is the best strategy to encourage early detection of BC.