Abstract
The impact of income and education level on the clinical and pathologic characteristics, implementation of clinical breast examination (CBE), and treatment patterns of a small population of Chinese female breast cancer patients was studied in order to provide a theoretical basis and statistical reference for further nationwide research. We included 484 pathologically confirmed female primary breast cancer inpatients of the First Affiliated Hospital of Medical College of Xi'an Jiaotong University from February 2003 to January 2004. All cases were reviewed and relevant information was collected using a designed case report form (CRF). Chi- square tests, rank-sum tests, and Fisher's exact tests were used in the analysis. Our analysis showed that: (1) women in different occupation groups had significant differences in tumor size, pre-operative mammography, surgical options, post-operative estrogen receptor (ER), progestin receptor (PR) and human epidermal growth factor receptor 2 (Her2) status, and post-operative radiotherapy and chemotherapy (P < 0.05); and (2) women with different education levels had statistically significant differences in tumor size, post-operative ER, PR and Her2 status, and post-operative chemotherapy, radiotherapy, and endocrine therapy (P < 0.05). In Xi'an, China, women in low-income occupations or with low education levels are more likely to have advanced tumor stages at presentation, lower implementation rate of clinical breast examination, and less treatment.
Highlights
Occupation and education level play a vital role in determining patients’ income levels and their perceptions of cancer, influencing an individual’s medical insurance status, the affordability of medical treatment costs, and the likelihood of early tumor detection and presentation
The “none” education group made up 2.9% (14/484) of all enrolled patients, while the remainder comprised those educated to primary school 8.1% (39/484), middle school 23.8% (115/484), high school 24.2% (117/484), and university and above
This study reports that occupation and education level significantly affect some of the clinical and pathologic characteristics of breast cancers presented in the clinic and the type of treatment option administered to patients
Summary
Occupation and education level play a vital role in determining patients’ income levels and their perceptions of cancer, influencing an individual’s medical insurance status, the affordability of medical treatment costs, and the likelihood of early tumor detection and presentation. All of these factors are closely related to the general incidence and development of tumors (Kent et al, 2009; Baade et al, 2010; Chung et al, 2010; Goldsbury et al, 2012), which are relevant to breast cancer patients. Studies on female breast cancer in Western countries may not be relevant to female breast cancer in Asian countries, such as China
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