Abstract
One of the major causes of death among females in Saudi Arabia is breast cancer. Newly diagnosed cases of breast cancer among the female population in Saudi Arabia is 19.5%. With this high incidence, it is crucial that we explore the determinants associated with breast cancer among the Saudi Arabia populace—the focus of this current study. The total sample size for this study is 8312 (8172 females and about 140 representing 1.68% males) patients that were diagnosed with advanced breast cancer. These are facility-based cross-sectional data collected over a 9-year period (2004 to 2013) from a routine health information system database. The data were obtained from the Saudi Cancer Registry (SCR). Both descriptive and inferential (Cox with log-normal and gamma frailties) statistics were conducted. The deviance information criterion (DIC), Watanabe–Akaike information criterion (WAIC), Bayesian information criterion (BIC), and Akaike information criterion were used to evaluate or discriminate between models. For all the six models fitted, the models which combined the fixed and random effects performed better than those with only the fixed effects. This is so because those models had smaller AIC and BIC values. The analyses were done using R and the INLA statistical software. There are evident disparities by regions with Riyadh, Makkah, and Eastern Province having the highest number of cancer patients at 28%, 26%, and 20% respectively. Grade II (46%) and Grade III (45%) are the most common cancer grades. Left paired site laterality (51%) and regional extent (52%) were also most common characteristics. Overall marital status, grade, and cancer extent increased the risk of a cancer patient dying. Those that were married had a hazard ratio of 1.36 (95% CI: 1.03–1.80) while widowed had a hazard ratio of 1.57 (95% CI: 1.14–2.18). Both the married and widowed were at higher risk of dying with cancer relative to respondents who had divorced. For grade, the risk was higher for all the levels, that is, Grade I (Well diff) (HR = 7.11, 95% CI: 3.32–15.23), Grade II (Mod diff) (HR = 7.89, 95% CI: 3.88–16.06), Grade III (Poor diff) (HR = 5.90, 95% CI (2.91–11.96), and Grade IV (Undiff) (HR = 5.44, 95% (2.48–11.9), relative to B-cell. These findings provide empirical evidence that information about individual patients and their region of residence is an important contributor in understanding the inequalities in cancer mortalities and that the application of robust statistical methodologies is also needed to better understand these issues well.
Highlights
Cancer of the breast known as breast cancer occurs when cells that are in the breast grow out of control, usually forming a tumour that can be detected by X-ray or felt as a lump
E data obtained and used in this analysis are from all the hospitals under the Ministry of Health and from the private hospitals, clinics, and laboratories. e data are abstracted from patients who are categorised as cancer patients via clinical, histopathological, and radiological diagnoses. e Saudi Cancer Registry (SCR) supervises all its offices across the regions to ensure accuracy and quality controls for data collection
In this paper, the effects of demographics, extent, topography, grade, and region on breast cancer patient risk of dying in Saudi Arabia. e study compared two advanced statistical approaches that have been used to correct for dependencies in data structures
Summary
Cancer of the breast known as breast cancer occurs when cells that are in the breast grow out of control, usually forming a tumour that can be detected by X-ray or felt as a lump. Several studies have identified breast cancer as one of the causes of death that occur in the Western world [1]. It is observed as one of the common malignancies among the people of Saudi Arabia, where it affects 21.8% of women. E Saudi Cancer Registry at the King Faisal Specialist Hospital and Research Centre stipulates that about 930 cancer cases are diagnosed yearly in Saudi Arabia or around 19.5% of Saudi and nonSaudi women. Al-Qahtani [2] found breast cancer to be among the top two common malignancies among Saudi Arabia women. In 2010, it was estimated to be the 9th most common cause of women mortality in the Kingdom of Saudi. Ibrahim et al [5] predicted that in the decade, there will be an increase due to population growth and aging
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