Do socioeconomic factors and primary care model affect early breast cancer diagnosis in a cohort of breast cancer patients in an urban Canadian centre?

Abstract

Objectives: Studies have shown an association between socioeconomic status (SES) and breast cancer (BC) treatment and diagnosis. We examined the relationship between SES, primary care physician (PCP) model and early detection of BC, as defined by asymptomatic screening and early stage at diagnosis, in a universal healthcare system.

Methods: Data were collected for consecutive patients diagnosed with BC from January 2010 to December 2011.Variables included patient and disease factors, type of PCP, stage at diagnosis and method of tumour identification. Area-level SES variables were obtained from 2006 Canadian census data. Multivariable logistic regression was used to identify predictors of early BC diagnosis. Odds ratios with 95% confidence intervals were reported.

Results: Results: A total of 721 patients were treated for breast cancer during the 2-year period. Predictors of early diagnosis through screening included: patients aged 51-70 (OR 4.3, 95% CI:2.6-7.2), BMI > 30 (1.5, 1.0-2.3), not employed (0.5, 0.3-0.8), and previous screening within 2 years (3.0, 2.0-4.4). Predictors of diagnosis at an early stage were having a 1^st degree relative with breast cancer (2.2, 1.3-3.8) and having screening at an Ontario Breast Screening Program (2.9, 1.6-5.2).

Conclusion: Certain patient variables such as age and family history, predicted the likelihood of early detection of BC by asymptomatic screening and diagnosis at an early stage. In our urban cohort of BC patients, SES factors were not found to be predictors of early detection of BC