Socioeconomic position and cancer stage at diagnosis in a fragmented Latin American health system

在拉丁美洲支离破碎的医疗体系中,社会经济地位和癌症诊断时的分期都会影响癌症的发生发展。

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Abstract

Early cancer diagnosis is crucial to improving disease prognosis. Although several studies have investigated the relationship between socioeconomic position (SEP) and stage at diagnosis, there is limited evidence from contexts with highly fragmented health systems and pronounced socioeconomic inequalities. This study analyzed the association between SEP and stage of cancer diagnosis. Data were obtained from the EquityCancer-LA baseline study. The sample included patients aged 18 or older with a confirmed cancer diagnosis within the 12 months prior to participation. Cancer stage was determined by the oncology committees of participating healthcare centers and logistic regression models were used to assess the association between SEP and cancer stage at diagnosis. A total of 343 individuals participated in the study, 39.1% of whom were diagnosed at a late stage. Two SEP indicators were associated with this outcome. After adjusting for covariates, participants without formal income had higher odds of late-stage diagnosis (OR = 2.14; 95% CI 1.02-4.53), and those who were non-head of household (OR = 1.83; 95% CI 1.11-3.02). When adjusting for all SEP variables, only non-head of household condition remained significantly associated (OR = 1.77; 95% CI 1.07-2.96). These results show that disadvantaged SEP was associated with higher odds of late-stage cancer diagnosis. The findings suggest the need for strategies that promote early diagnosis and address the socioeconomic inequities identified in this study.

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