Socioeconomic Inequalities in Metastasis, Recurrence, Stage and Grade of Breast Cancer: A Hospital-based Retrospective Cohort Study


Socio-Economic Status
Concentration Index
Breast Cancer


Background: This study aims to estimate the Socio-Economic Status (SES) inequality on the metastasis, recurrence, stage and grade in Breast Cancer (BC).

Methods: This retrospective cohort study conducted on 411 BC patients in Arak, Iran. Asset-based questionnaire used to estimate the household SES. For calculate of SES inequality was used from Concentration Index (C). Moreover for investigate the association between recurrence and metastasis with other variables were used from multilevel logistic regression and analysis of variance were used to investigate the relationship between SES and other variables. The data were analyzed with Stata (v.13) software.

Results: Results of analysis of variance showed statistical significant relationship between SES with, insurance, surgery, grade, stage, recurrence and metastasis (p-value < 0.05). Moreover the Odds Ratio (OR) were significant of recurrence with age, academic level of education, supplementary insurance history of BC in first-degree relatives, stage and grade, also, metastasis with age of >80 years, insurance, supplementary insurance, history of BC in first-degree relatives, chemotherapy, radiotherapy, stage and grade four. The total C index obtained 0.015 (0.002, 0.026), 0.011 (0.003, 0.031), -0.014 (-0.034, -0.001) and -0.042 (-0.061, -0.002) for metastasis, recurrence, stage and grade of BC respectively.

Conclusion: Our results showed evidence of inequality in the metastasis, recurrence, stage and grade in BC patients.


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