Abstract
Late diagnosis of breast cancer is associated with lower survival. This study determines the factors associated with late-stage breast cancer diagnosis in an urban safety-net hospital (SNH) with excess late-stage disease. Single-institution retrospective study of all early-stage vs. late-stage breast cancer cases diagnosed or treated at the primary SNH in the Kansas City, Missouri area between January 2011-July 2018. Multiple logistic regression was performed to determine the variables that contributed most to late stage at diagnosis. The most significant factor associated with late-stage diagnosis was lack of screening mammogram within two years of diagnosis (p<.0001, OR 7.5, CI = 3.6, 15.3). Patients referred from within the SNH compared with those presenting from community health centers were significantly less likely to present with late-stage disease (p=.04, OR 0.50, CI = 0.25, 0.98). Screening mammography ought to be actively promoted in SNH settings with excess late-stage diagnosis.
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