A Multilevel Assessment of the Social Determinants Associated with the Late Stage Diagnosis of Breast Cancer

Overview

Journal Sci Rep

Specialty Science

Date 2021 Feb 2

PMID 33526801

Citations 9

Authors

Nayara Priscila Dantas de Oliveira

Marianna de Camargo Cancela

Luis Felipe Leite Martins

Dyego Leandro Bezerra de Souza

Affiliations

Soon will be listed here.

Abstract

The advanced-stage diagnosis of breast cancer reveals the inequalities associated with socioeconomic conditions and the offer of health services. This study analyzes the prevalence of advanced breast cancer and its relationship with individual and contextual socioeconomic indicators and offer of health service. A cross-sectional study is presented herein, on the assessment of malignant breast neoplasms in women diagnosed between 2006 and 2015 (n = 195,201). Data were collected from the Hospital Cancer Registry (HCR), Atlas of Human Development in Brazil, and from the National Registry of Health Institutions (NRHI). A multilevel Poisson Regression was carried out with random intercept. The prevalence of advanced breast cancer diagnosis was 40.0%. Advanced staging was associated with younger age groups (PR 1.41), race/nonwhite (PR 1.13), lower education levels (PR 1.38), and public access to health services (PR 1.25). There was also an association with a low density of mammographic equipment (PR 1.08), and with low indices of local social inequality (PR 1.33) and human development (PR 0.80). This study maps and highlights the causes related to inequalities in the diagnosis of advanced breast cancer in Brazil, and presents essential data to reorient public policies and health-related actions to strengthen the control of breast cancer in Brazil.

Citing Articles

Culture, community, and cancer: understandings of breast cancer from a non-lived experience among women living in Soweto.

Malope S, Norris S, Joffe M BMC Womens Health. 2024; 24(1):594.

PMID: 39506786 PMC: 11539428. DOI: 10.1186/s12905-024-03431-2.

Comprehensive diagnosis of advanced-stage breast cancer: exploring detection methods, molecular subtypes, and demographic influences - A cross-sectional study.

Silva Rivas F, Goncalves R, Mota B, Sorpreso I, Toporcov T, Filassi J Clinics (Sao Paulo). 2024; 79:100510.

PMID: 39413498 PMC: 11530810. DOI: 10.1016/j.clinsp.2024.100510.

Culture, community, and cancer: Understandings of breast cancer from a non-lived experience among women living in Soweto.

Malope S, Norris S, Joffe M Res Sq. 2024; .

PMID: 39257971 PMC: 11384026. DOI: 10.21203/rs.3.rs-4797158/v1.

Multilevel analysis of social determinants of advanced stage colorectal cancer diagnosis.

Dantas A, de Oliveira N, Costa G, Leite Martins L, Monteiro Dos Santos J, Migowski A Sci Rep. 2024; 14(1):9667.

PMID: 38671078 PMC: 11053035. DOI: 10.1038/s41598-024-60449-0.

Cancer inequalities in incidence and mortality in the State of São Paulo, Brazil 2001-17.

Guimaraes Ribeiro A, Ferlay J, Vaccarella S, Latorre M, Fregnani J, Bray F Cancer Med. 2023; 12(15):16615-16625.

PMID: 37345901 PMC: 10469722. DOI: 10.1002/cam4.6259.

References

. [Information integration of Brazilian cancer registries]. Rev Saude Publica. 2007; 41(5):865-8. DOI: 10.1590/s0034-89102007000500024. View

Rocha-Brischiliari S, Andrade L, Nihei O, Brischiliari A, Hortelan M, de Barros Carvalho M . Spatial distribution of breast cancer mortality: Socioeconomic disparities and access to treatment in the state of Parana, Brazil. PLoS One. 2018; 13(10):e0205253. PMC: 6209172. DOI: 10.1371/journal.pone.0205253. View

Figueiredo F, do Carmo Almeida T, Schoueri J, Luisi C, Adami F . Association between primary care coverage and breast cancer mortality in Brazil. PLoS One. 2018; 13(8):e0200125. PMC: 6071967. DOI: 10.1371/journal.pone.0200125. View

Li J, Shao Z . Mammography screening in less developed countries. Springerplus. 2015; 4:615. PMC: 4627993. DOI: 10.1186/s40064-015-1394-8. View

Vieira R, Biller G, Uemura G, Ruiz C, Curado M . Breast cancer screening in developing countries. Clinics (Sao Paulo). 2017; 72(4):244-253. PMC: 5401614. DOI: 10.6061/clinics/2017(04)09. View

Ren J, Gong Y, Ling H, Hu X, Shao Z . Racial/ethnic differences in the outcomes of patients with metastatic breast cancer: contributions of demographic, socioeconomic, tumor and metastatic characteristics. Breast Cancer Res Treat. 2018; 173(1):225-237. PMC: 6394580. DOI: 10.1007/s10549-018-4956-y. View

Unger-Saldana K . Challenges to the early diagnosis and treatment of breast cancer in developing countries. World J Clin Oncol. 2014; 5(3):465-77. PMC: 4127616. DOI: 10.5306/wjco.v5.i3.465. View

Abrahao K, Bergmann A, de Aguiar S, Thuler L . Determinants of advanced stage presentation of breast cancer in 87,969 Brazilian women. Maturitas. 2015; 82(4):365-70. DOI: 10.1016/j.maturitas.2015.07.021. View

Ramaswami R, Paulino E, Barrichello A, Nogueira-Rodrigues A, Bukowski A, St Louis J . Disparities in Breast, Lung, and Cervical Cancer Trials Worldwide. J Glob Oncol. 2018; 4:1-11. PMC: 6223472. DOI: 10.1200/JGO.17.00226. View

10.

San Miguel Y, Gomez S, Murphy J, Schwab R, McDaniels-Davidson C, Canchola A . Age-related differences in breast cancer mortality according to race/ethnicity, insurance, and socioeconomic status. BMC Cancer. 2020; 20(1):228. PMC: 7076958. DOI: 10.1186/s12885-020-6696-8. View

11.

Ji P, Gong Y, Jiang C, Hu X, Di G, Shao Z . Association between socioeconomic factors at diagnosis and survival in breast cancer: A population-based study. Cancer Med. 2020; 9(5):1922-1936. PMC: 7050085. DOI: 10.1002/cam4.2842. View

12.

Moller H, Henson K, Luchtenborg M, Broggio J, Charman J, Coupland V . Short-term breast cancer survival in relation to ethnicity, stage, grade and receptor status: national cohort study in England. Br J Cancer. 2016; 115(11):1408-1415. PMC: 5129821. DOI: 10.1038/bjc.2016.335. View

13.

Migowski A, Azevedo E Silva G, Dias M, Diz M, SantAna D, Nadanovsky P . Guidelines for early detection of breast cancer in Brazil. II - New national recommendations, main evidence, and controversies. Cad Saude Publica. 2018; 34(6):e00074817. DOI: 10.1590/0102-311X00074817. View

14.

Pace L, He Y, Keating N . Trends in mammography screening rates after publication of the 2009 US Preventive Services Task Force recommendations. Cancer. 2013; 119(14):2518-23. DOI: 10.1002/cncr.28105. View

15.

Williams F, Thompson E . Disparity in Breast Cancer Late Stage at Diagnosis in Missouri: Does Rural Versus Urban Residence Matter?. J Racial Ethn Health Disparities. 2016; 3(2):233-9. PMC: 6314175. DOI: 10.1007/s40615-015-0132-9. View

16.

Ferreira N, de Carvalho S, Valenti V, Bezerra I, Teixeira Batista H, de Abreu L . Treatment delays among women with breast cancer in a low socio-economic status region in Brazil. BMC Womens Health. 2017; 17(1):13. PMC: 5320774. DOI: 10.1186/s12905-016-0359-6. View

17.

Malta D, Bernal R, Vieira Neto E, Curci K, Pasinato M, Lisboa R . Trends in risk and protective factors for non-communicable diseases in the population with health insurance in Brazil from 2008 to 2015. Rev Bras Epidemiol. 2018; 21(suppl 1):e180020. DOI: 10.1590/1980-549720180020.supl.1. View

18.

de Oliveira N, Guedes T, Martins Holanda A, Albuquerque Reis M, Silva C, Rocha E Silva B . Functional Disability in Women Submitted to Breast Cancer Treatment. Asian Pac J Cancer Prev. 2017; 18(5):1207-1214. PMC: 5555524. DOI: 10.22034/APJCP.2017.18.5.1207. View

19.

Figueiredo F, Adami F . Effects of the high-inequality of income on the breast cancer mortality in Brazil. Sci Rep. 2019; 9(1):4173. PMC: 6414632. DOI: 10.1038/s41598-019-41012-8. View

20.

Rust G, Zhang S, Malhotra K, Reese L, McRoy L, Baltrus P . Paths to health equity: Local area variation in progress toward eliminating breast cancer mortality disparities, 1990-2009. Cancer. 2015; 121(16):2765-74. PMC: 4540479. DOI: 10.1002/cncr.29405. View