Research article

BMC Cancer

, 12:122

Open Access This content is freely available online to anyone, anywhere at any time.

Breast cancer stage at diagnosis and area-based socioeconomic status: a multicenter 10-year retrospective clinical epidemiological study in China

  • Qiong WangAffiliated withDepartment of Epidemiology, West China School of Public Health, Sichuan UniversityDepartment of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
  • , Jing LiAffiliated withDepartment of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
  • , Shan ZhengAffiliated withDepartment of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
  • , Jia-Yuan LiAffiliated withDepartment of Epidemiology, West China School of Public Health, Sichuan University Email author 
  • , Yi PangAffiliated withDepartment of Epidemiology, West China School of Public Health, Sichuan University
  • , Rong HuangAffiliated withDepartment of Epidemiology, West China School of Public Health, Sichuan UniversityDepartment of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
  • , Bao-Ning ZhangAffiliated withCenter of Breast Disease, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
  • , Bin ZhangAffiliated withCenter of Breast Disease, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Breast Surgery, Liaoning Cancer Hospital
  • , Hong-Jian YangAffiliated withDepartment of Breast Surgery, Zhejiang Cancer Hospital
    • , Xiao-Ming XieAffiliated withDepartment of Breast Oncology, Sun Yat-Sen University Cancer Center
    • , Zhong-Hua TangAffiliated withDepartment of Breast-thyroid Surgery, Xiangya Sencod Hospital, Central South University
    • , Hui LiAffiliated withDepartment of Breast Surgery, the Second People’s Hospital of Sichuan Province
    • , Jian-Jun HeAffiliated withDepartment of Oncosurgery, the First Affiliated Hospital of Medical College, Xi’an Jiao Tong University
    • , Jin-Hu FanAffiliated withDepartment of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Email author 
    • , You-Lin QiaoAffiliated withDepartment of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College

Abstract

Background

Although socioeconomic status (SES) has been focused on as a key determinant of cancer stage at diagosis in western countries, there has been no systemic study on the relationship of SES and breast cancer stage at diagnosis in China.

Methods

The medical charts of 4,211 eligible breast cancer patients from 7 areas across China who were diagnosed between 1999 and 2008 were reviewed. Four area-based socioeconomic indicators were used to calculate area-based SES by cluster analysis. The associations between area-based SES and stage at diagnosis were analyzed by trend chi-square tests. Binary logistic regression was performed to estimate odds ratios for individual demographic characteristics' effects on cancer stages, stratified by area-based SES.

Results

The individual demographic and pathologic characteristics of breast cancer cases were significantly different among the seven areas studied. More breast cancer cases in low SES areas (25.5%) were diagnosed later (stages III & IV) than those in high (20.4%) or highest (14.8%) SES areas (χ 2 for trend = 80.79, P < 0.001). When area-based SES is controlled for, in high SES areas, cases with less education were more likely to be diagnosed at later stages compared with more educated cases. In low SES areas, working women appeared to be diagnosed at earlier breast cancer stages than were homemakers (OR: 0.18-0.26).

Conclusions

In China, women in low SES areas are more likely to be diagnosed at later breast cancer stages than those in high SES areas.

Keywords

Breast cancer Stage at diagnosis Area-based socioeconomic status Nation-wide Multi-center Retrospective study