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

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BMC Cancer

, 12:122

First Online: 29 March 2012Received: 20 November 2011Accepted: 29 March 2012DOI: 10.1186-1471-2407-12-122

Cite this article as: Wang, Q., Li, J., Zheng, S. et al. BMC Cancer 2012 12: 122. doi:10.1186-1471-2407-12-122


BackgroundAlthough 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.

MethodsThe 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.

ResultsThe 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 and IV than those in high 20.4% or highest 14.8% SES areas χ 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.

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

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

SEIsSocioeconomic indicators

SEERSurveillance Epidemiology and End Results

HSEpercentage Percentage of health-service expenditure in the regional-provincial public affairs general budget

PU-PRratio Ratio of urban to rural population

FPIpercentage Percentage of illiteracy in females aged 15 and over

CICAMSChinese Academy of Medical Sciences

AJCCAmerican Joint Committee on Cancer

EREstrogen receptor

PRProgestin receptor

Her-2Human epidermal growth factor receptor 2

CRFCase report form

CBEClinical breast examination

MRIMagnetic resonance imaging

BHGIBreast Health Global Initiative.

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Author: Qiong Wang - Jing Li - Shan Zheng - Jia-Yuan Li - Yi Pang - Rong Huang - Bao-Ning Zhang - Bin Zhang - Hong-Jian Yang - Xi



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