Sociodemographic determinants of early and late presentation of breast cancer: a hospital-based cross-sectional study from a tertiary care centre in Western Uttar Pradesh, India

Authors

  • Pratibha Singh Department of Community Medicine, SN Medical College, Agra, Uttar Pradesh, India
  • Renu Agrawal Department of Community Medicine, SN Medical College, Agra, Uttar Pradesh, India
  • Surabhi Gupta Department of Radiotherapy, SN Medical College, Agra, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20261027

Keywords:

Breast cancer, Presentation delay, Sociodemographic factors, Early presenter, Late presenter, Breast self-examination

Abstract

Background: Breast cancer is the leading cancer among women in India, with late presentation substantially worsening treatment outcomes. Understanding sociodemographic profiles of early versus late presenters is essential for designing targeted interventions in tertiary care settings.

Methods: A hospital-based cross-sectional study was conducted at Sarojini Naidu Medical College, Agra, from 2023 to 2025, enrolling ninety-five breast cancer patients (≥18 years) attending OPD. Early presenters had no delay in seeking treatment after symptom recognition, whereas late presenters reported a delay. Sociodemographic characteristics (age, education, occupation, marital status, parity, family income) were collected using a pre-tested semi-structured questionnaire and analyzed using chi-square tests and multivariable logistic regression, with p<0.05 considered significant.

Results: Of 95 patients, 31 (32.6%) were early presenters and 64 (67.4%) late presenters. The mean age was 39.2±11.8 years; most were housewives, married and from lower-income families. Late presenters had a higher mean number of children (2.67±1.31 vs 1.87±1.01), and 53.1% had ≥3 children compared with 22.6% among early presenters. Illiteracy was independently associated with 5.2-fold higher odds of late presentation (95% CI 1.54–17.4). Homemaker status also significantly predicted delay, while breast self-examination practice and screening awareness were more common among early presenters.

Conclusions: Illiteracy, homemaker status and higher parity independently predicted late breast cancer presentation, with education level emerging as the strongest sociodemographic determinant. Greater reproductive burden was significantly associated with delays, underscoring the need for empowerment-focused, culturally sensitive interventions targeting low-literacy homemakers with higher parity, alongside structural health system strengthening to facilitate timely care.

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References

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. DOI: https://doi.org/10.3322/caac.21660

Kumari R, Singh A, Sharma S, Verma R. Sociodemographic Profile, Reproductive Factors and Presentation Pattern in Breast Cancer Patients from North India: A Hospital Based Study. J Pharm Bioallied Sci. 2025;17(Suppl 5):S3766–S3768. DOI: https://doi.org/10.4103/jpbs.jpbs_1187_25

Mangayarkarasi V, Durairaj E, Ramanathan V. Enhancing cancer screening and early diagnosis in India: Overcoming challenges and leveraging emerging technologies. Cureus. 2025;17(2):e78808. DOI: https://doi.org/10.7759/cureus.78808

Syamsidar T, Muis SF, Lubis SL, Santoso B, Prameswari A. Sociodemographic disparities associated with advanced stages and distant metastatic breast cancers at diagnosis in Indonesia: a cross-sectional study. Ann Med Surg (Lond). 2023 Aug 1;85(9):4211–7. DOI: https://doi.org/10.1097/MS9.0000000000001030

Pace LE, Mpunga T, Hategekimana V, Dusengimana JMV, Habineza H, Bigirimana JB, et al. Delays in breast cancer presentation and diagnosis at an academic hospital in Rwanda. Oncologist. 2015;20(7):780-8. DOI: https://doi.org/10.1634/theoncologist.2014-0493

Mittra I, Mishra GA, Dikshit RP, Gupta S, Kulkarni VY, Shaikh HKA, et al. Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: Prospective, cluster randomized controlled trial in Mumbai. BMJ. 2021;372:n256. DOI: https://doi.org/10.1136/bmj.n256

India State-Level Disease Burden Initiative Cancer Collaborators. The burden of cancers and their variations across the states of India: The global burden of disease study 1990-2016. Lancet Oncol. 2018;19(10):1289-306.

Gupta R, Gupta S, Mehrotra R, Sodhani P. Risk factors of breast cancer and breast self-examination in early detection: Systematic review of awareness among Indian women in community and health care professionals. J Public Health. 2020;42(1):118-31. DOI: https://doi.org/10.1093/pubmed/fdy228

International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-5), 2019-21: India. Mumbai: IIPS. 2021. Available at: https://rchiips.org/nfhs/factsheet_NFHS-5.shtml. Accessed on 13 November 2025.

Patta MK, Shankar G, Ahmed FM. Why are you late? A descriptive study of delay in treatment seeking among patients of carcinoma breast presenting to a tertiary care hospital in South India. Indian Cancer Awareness J. 2024;3:9-16. DOI: https://doi.org/10.25259/ICAJ_4_2024

Saldaña-Téllez M, Meneses-Navarro S, Cano-Garduño L, Unger-Saldaña K. Barriers and facilitators for breast cancer early diagnosis in an indigenous community in Mexico: Voices of Otomí women. BMC Women’s Health. 2024;24:33. DOI: https://doi.org/10.1186/s12905-023-02875-2

Kaur K, Jajoo R, Naman S, Kandwal T, Brar GS, Garg P, et al. Identifying barriers to early diagnosis of breast cancer and perception of women in Malwa region of Punjab, India. Glob Health J. 2023;7(1):34-42. DOI: https://doi.org/10.1016/j.glohj.2023.02.006

Nandini C, Roopakala N, Andanigoudar KB. Barriers to early diagnosis and treatment among breast cancer survivors: Qualitative study in a tertiary care hospital, North Karnataka. Natl J Community Med. 2022;13(3):190-4. DOI: https://doi.org/10.55489/njcm.1332022398

Palaniraja S, Taghavi K, Kataria I, Oswal K, Vani NV, Liji AA, et al. Barriers and contributions of rural community health workers in enabling cancer early detection and subsequent care in India: A qualitative study. BMC Public Health. 2025;25(1):1527. DOI: https://doi.org/10.1186/s12889-025-22735-y

Kathrikolly TR, Shetty RS, Nair S. Opportunities and barriers to breast cancer screening in a rural community in coastal Karnataka, India: A qualitative analysis. Asian Pac J Cancer Prev. 2020;21(9):2569-75. DOI: https://doi.org/10.31557/APJCP.2020.21.9.2569

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Published

2026-03-31

How to Cite

Singh, P., Agrawal, R., & Gupta, S. (2026). Sociodemographic determinants of early and late presentation of breast cancer: a hospital-based cross-sectional study from a tertiary care centre in Western Uttar Pradesh, India. International Journal Of Community Medicine And Public Health, 13(4), 1883–1890. https://doi.org/10.18203/2394-6040.ijcmph20261027

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Original Research Articles