{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:07:17Z","timestamp":1791338837674,"version":"4.3.1"},"reference-count":23,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>The majority of Egyptian patients with breast cancer (BC) present at advanced stages. We examined the sociodemographic and clinical factors associated with late presentation of BC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>A retrospective cohort study was conducted on patients who presented with BC between 2011 and 2020. Logistic regression analysis was used to examine the association between sociodemographic factors and advanced-stage BC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>This cohort included 1,953 patients with a median age of 52 years. Among them, 1,098 (56.2%) patients were diagnosed at early stages, whereas 855 (43.8%) were diagnosed at advanced stages. Univariable logistic regression revealed several factors associated with advanced BC, including having a negative family history of BC (odds ratio [OR], 1.27 [95% CI, 1.05 to 1.54]), having no job (OR, 1.28 [95% CI, 1.06 to 1.53]), being married (OR, 1.27 [95% CI, 1.02 to 1.57]), rural residence (OR, 1.27 [95% CI, 1.02 to 1.57]), having more than three children (OR, 1.42 [95% CI, 1.15 to 1.75]), higher Ki67% score (OR, 1.01 [95% CI, 1.00 to 1.01]), having human epidermal growth factor receptor 2\u2013overexpressed or triple-negative BC subtypes (OR, 1.44 [95% CI, 1.16 to 1.79]), and having tumor grade 2\/3 (OR, 4.12 [95% CI, 1.58 to 10.77 and OR, 1.44 [95% CI, 1.16 to 1.79], respectively). In the multivariable logistic regression model, only higher Ki67% (adjusted odds ratio [aOR], 1.01 [95% CI, 1.00 to 1.02]), having no job (aOR, 1.44 [95% CI, 1.10 to 1.90]), and rural residence (aOR, 1.88 [95% CI, 1.03 to 3.42]) were significantly associated with advanced BC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>This study concluded that having no job and rural residence are strongly associated with advanced BC. Raising public awareness is essential to encourage early detection of BC.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/go-25-00108","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:59:09Z","timestamp":1756929549000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Social Determinants Associated With the Advanced-Stage Diagnosis of Breast Cancer"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3424-310X","authenticated-orcid":true,"given":"Madonna A.","family":"Fekry","sequence":"first","affiliation":[{"name":"Clinical Research Department, Cairo Oncology Center, Cairo, Egypt"},{"name":"Centre for Public Health, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6559-5867","authenticated-orcid":true,"given":"Loay","family":"Kassem","sequence":"additional","affiliation":[{"name":"Clinical Oncology Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt"},{"name":"Medical Oncology Unit, Cairo Oncology Center, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-4906","authenticated-orcid":true,"given":"Justin C.","family":"Yang","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom"},{"name":"Division of Psychiatry, University College London, London, United Kingdom"},{"name":"North London NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdy A.","family":"Azim","sequence":"additional","affiliation":[{"name":"Clinical Oncology Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt"},{"name":"Medical Oncology Unit, Cairo Oncology Center, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","volume-title":"Breast Cancer","author":"WHO","year":"2021","unstructured":"WHO: Breast Cancer. 2021. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/breast-cancer"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-16-7945-2_4"},{"key":"e_1_3_6_4_2","article-title":"Clinicopathologic features of breast cancer in Egypt\u2014Contemporary profile and future needs: A systematic review and meta-analysis","author":"Azim HA","unstructured":"Azim HA, Elghazawy H, Ghazy RM, et al.: Clinicopathologic features of breast cancer in Egypt\u2014Contemporary profile and future needs: A systematic review and meta-analysis. 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