Nayab Khan, Riaz Ahmad, Muhammad Nadeem, Iftikhar Hussain.
Influence of Education and Socio-Economic Factors on Stage of Cancer Diagnosis: A Study in Pakistani Population.
Ann Pak Inst Med Sci Jan ;12(4):225-8.

Objective: To determine the influence of education level and income on the stage of diagnosis of cancer at the time of first presentation Place and Duration: This cross-sectional study was conducted at the Department of Oncology, Combined Military Hospital Rawalpindi and Multan from August 2016 till November 2016. Materials and methods: A total of 200 newly diagnosed patients were included in the study. Previously treated, relapsed or secondary malignancy patients were excluded. Patients were interviewed regarding their demographic profile and socioeconomic status and stage of disease was determined by relevant investigations. Results: The total number of patients was 200, out of which 59% (118) were male and 41% (82) were female. 18.5% (37) patients had high income, 64.5% (129) had medium income and 17% (34) had low income. 8.11% of high income patients were diagnosed at stage-1 disease and only 24.32% patients had metastatic disease at the time of diagnosis. None of the low income patients was diagnosed at stage-1 and over 30% of low and middle income patients had stage IV disease at presentation. 12.5% (25) of patients were highly educated, 51% (102) had middle education while 36.5% (73) had low education. 28% of highly educated patients presented with stage IV disease at diagnosis, in contrast to 40.2% of middle and 38.36% of low education patients diagnosed with stage IV disease at first presentation Conclusions: Lower level of education and prevailing poverty is a major contributing factor in delayed diagnosis of malignancies, hence making the treatment difficult and prognosis poorer.

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