SOCIOECONOMIC INEQUALITY IN STAGE AT DIAGNOSIS OF NASOPHARYNGEAL CARCINOMA: A CROSS-SECTIONAL STUDY
ABSTRACT: Nasopharyngeal
carcinoma (NPC) is head and neck cancer with the highest incidencein Indonesia,
and leads Indonesia as one of the countries with the highest incidence of NPC
in the world.Early diagnosis is an important prognostic factor in NPC
management. However, most of the NPC patientswere diagnosed at the advanced
stage. Delayed diagnosis is contributed by several factors
includingsocioeconomic status.
Objective: To find out the association between socioeconomic status with
stageat diagnosis of NPC patients in Indonesia.
Methods: A cross-sectional study was conducted and 57 NPCpatients were
consecutively recruited from ENT clinic Margono Soekarjo Hospital as study
subjects.Socioeconomic status was measured by income level, educational level,
employment status, and healthinsurance coverage. Stages at diagnosis were
categorized into early and advanced stage based on theclinical stage. Degree of
socioeconomic inequality was analyzed by logistic regression.
Results: Incomelevel below poverty line (OR 5.39; 95% CI: 1.36-22.42),
basic educational level (OR=3.81; 95% CI:1.11–13.09), currently employed
(OR=3.59; 95% CI: 1.07–12.00) had higher probability to be diagnosedat advanced
stage. After multivariate analysis, only employment status (OR=5.74; 95% CI:
1.25 – 26.21)contributed significantly to probability of being diagnosed at
advanced stage.
Conclusion: Socioeconomicstatus was associated with stage diagnosis of
NPC levels. Socioeconomic inequality in stage at diagnosisof NPC patients did
exist in Indonesia, and employment status was the most contributing factor.
Keywords: Socioeconomic
status, inequality, stage at diagnosis, nasopharyngeal carcinoma
Penulis: Joko Mulyanto, Anton
Budhi Darmawan, Anisa Kapti
Kode Jurnal: jpkedokterandd160727
