Adjusted Associations of Late-Stage Diagnosis (AJCC III, IV) of Breast Cancer (n = 79,843)
| Characteristic | Adjusted ORa | 95% Wald CL | P Value |
|---|---|---|---|
| Total ambulatory primary care physician visits | |||
| 0–1 (referent) | 1.00 | – | – |
| 2–4 | 0.57 | 0.53, 0.61 | <.001 |
| 5–10 | 0.49 | 0.46, 0.52 | <.001 |
| ≥11 | 0.50 | 0.47, 0.53 | <.001 |
| Total ambulatory non– primary care physician visits | |||
| 0–1 (referent) | 1.00 | – | – |
| 2–4 | 0.62 | 0.58, 0.66 | <.001 |
| 5–10 | 0.55 | 0.51, 0.58 | <.001 |
| ≥11 | 0.46 | 0.42, 0.49 | <.001 |
| Age at diagnosis | |||
| 67–75 (referent) | 1.00 | – | – |
| 76–85 | 1.21 | 1.15, 1.27 | <.001 |
| ≥86 | 1.67 | 1.55, 1.79 | <.001 |
| Race/ethnicity | |||
| White, non-Hispanic (referent) | 1.00 | – | – |
| Black, non-Hispanic | 1.38 | 1.27, 1.50 | <.001 |
| Hispanic | 1.32 | 1.19, 1.48 | <.001 |
| Asian/American Indian/Pacific | 0.84 | 0.72, 0.98 | .03 |
| Islander | |||
| Other | 0.76 | 0.53, 1.08 | .13 |
| Marital status | |||
| Married (referent) | 1.00 | – | – |
| Never married | 1.38 | 1.27, 1.50 | <.001 |
| Separated/divorced | 1.25 | 1.14, 1.37 | <.001 |
| Widowed | 1.24 | 1.18, 1.31 | <.001 |
| Unknown | 1.23 | 1.08, 1.39 | .001 |
| Education level of residence | |||
| Quintile 1 (lowest) (referent) | 1.00 | – | – |
| Quintile 2 | 0.98 | 0.91, 1.05 | .54 |
| Quintile 3 | 0.94 | 0.86, 1.02 | .12 |
| Quintile 4 | 0.87 | 0.79, 0.95 | .002 |
| Quintile 5 | 0.81 | 0.73, 0.90 | <.001 |
| Income level of residence | |||
| Quintile 1 (lowest) (referent) | 1.00 | – | – |
| Quintile 2 | 1.00 | 0.93, 1.08 | .90 |
| Quintile 3 | 1.05 | 0.97, 1.14 | .22 |
| Quintile 4 | 1.08 | 0.99, 1.19 | .09 |
| Quintile 5 | 1.06 | 0.95, 1.18 | .28 |
| MSA of residence | |||
| Large metropolitan (referent) | 1.00 | – | – |
| Metropolitan | 0.97 | 0.91, 1.04 | .42 |
| Urban | 0.96 | 0.86, 1.08 | .49 |
| Less urban | 0.84 | 0.75, 0.95 | .004 |
| Rural | 0.83 | 0.68, 1.00 | .06 |
| Year of diagnosis | |||
| 1994–1997 (referent) | 1.00 | – | – |
| 1998–2000 | 0.90 | 0.84, 0.97 | .004 |
| 2001–2005 | 1.09 | 1.02, 1.16 | .01 |
| Charlson comorbidity index | |||
| 0 (referent) | 1.00 | – | – |
| 1 | 1.02 | 0.96, 1.08 | .52 |
| ≥2 | 1.21 | 1.13, 1.29 | <.001 |
| Influenza vaccination | |||
| No (referent) | 1.00 | – | – |
| Yes | 0.72 | 0.69, 0.76 | <.001 |
AJCC = American Joint Commission on Cancer; CL = confidence limits; MSA = metropolitan statistical area; PCP = primary care physician.
Note: Patients with stage 0 carcinoma (in situ) or missing were excluded.
↵a Odds ratios indicate odds of late-stage (AJCC stages III, IV) diagnosis of breast cancer relative to early stage (AJCC stages I, II). Logistic models also include indicator variables for cancer registry (data not presented).