DOI: https://doi.org/10.36347/sjams.2025.v13i08.011

Pages: 1602-1607

Background: Breast cancer is the most frequently diagnosed cancer among women globally, with a rising burden in low- and middle-income countries, including Bangladesh. While the Chittagong Metropolitan Area (CMA) benefits from urban healthcare access, the Chittagong Hill Tracts (CHT) region remains socioeconomically and geographically marginalised. This study examines and compares the age distribution, socio-economic determinants, and stage at diagnosis of breast cancer among women in these two distinct regions. Methods: A comparative cross-sectional study was conducted among 301 women with histologically confirmed primary breast cancer. Data were collected through structured interviews and clinical record reviews at Chittagong Medical College Hospital. Sociodemographic characteristics, awareness levels, and diagnostic stages were analysed using descriptive statistics, bivariate analyses, and multivariable logistic regression models. Results: Women in the CHT were diagnosed at a younger age (mean: 42.0 vs. 47.2 years) and had significantly lower education and income levels compared to their CMA counterparts. Late-stage diagnosis (Stage III/IV) was more prevalent in CHT (58%) than CMA (33%). Independent predictors of late-stage diagnosis included CHT residence (adjusted OR [aOR] = 2.4; 95% CI: 1.7–3.5), no formal education (aOR = 2.7; 95% CI: 1.8–4.1), household income <5,000 BDT/month (aOR = 2.3; 95% CI: 1.6–3.4), lack of breast cancer awareness (aOR = 1.9; 95% CI: 1.3–2.7), and treatment delay ≥3 months (aOR = 2.5; 95% CI: 1.8–3.6). Conclusion: The findings highlight stark inequities in breast cancer diagnosis linked to geography, socio-economic disadvantage, and awareness gaps. Women in the CHT face significantly higher odds of late-stage presentation. Urgent, culturally sensitive public health strategies are needed to improve early detection and outcomes among indigenous and rural populations in Bangladesh.