Shen Yu, Cai Hongyu, Zhou Dan, Gao Jinliang, Yang Tinghan, Chen Haining, Wei Mingtian, Wang Ziqiang
Department of General Surgery, Colorectal Cancer Center, West China Hospital, Sichuan University, Sichuan Province, No. 37 Guo Xue Xiang Street, Chengdu, China.
School of Economics, Sichuan University, Sichuan Province, Chengdu, China.
Updates Surg. 2025 Jan;77(1):119-132. doi: 10.1007/s13304-024-02024-w. Epub 2024 Nov 20.
Studying the epidemiological and management characteristics of colorectal cancer (CRC) between China and the US has important implications. The present cross-sectional study included patients from SEER and Southwest China Colorectal (SCC) databases. Incidence, treatment and survival information were compared between two countries. 86859 patients in the SEER database and 5838 patients in the SCC database were included. The estimated incidence of CRC in the US was greater than that in China from 2006 to 2019. The most common tumor sites of CRC patients in China were the RSC (66.5%), RCC (20.2%) and LCC (13.3%), while those in the US were the RCC (44.4%), RSC (29.8%) and LCC (25.8%). Chinese CRC patients were more likely to be male (58.9% vs 52.4%, p < 0.001), have a greater stage II CRC rate (49.8% vs 27.8%, p < 0.001), younger age at diagnosis (median 64 vs 66 years, p < 0.001). Radical surgery rates were lower in Chinese RCC (92.3% vs 93.9%, p < 0.001) and LCC (88.9% vs 92.0%, p < 0.001) patients. The adjuvant therapy rates were lower in Chinese CRC patients. The 5-year overall survival rates were 71.8% and 78.2% for Chinese and US CRC patients, respectively (p < 0.001). China is undergoing an increasing incidence of CRC. The treatment and mortality of CRC differ in China and US populations. China had a lower adjuvant therapy rate and a lower 5-year OS rate compared with the US.
研究中美两国结直肠癌（CRC）的流行病学和治疗特点具有重要意义。本横断面研究纳入了来自美国监测、流行病学和最终结果（SEER）数据库以及中国西南结直肠癌（SCC）数据库的患者。比较了两国的发病率、治疗情况和生存信息。SEER数据库纳入了86859例患者，SCC数据库纳入了5838例患者。2006年至2019年期间，美国CRC的估计发病率高于中国。中国CRC患者最常见的肿瘤部位是右半结肠癌（RSC，66.5%）、直肠癌（RCC，20.2%）和左半结肠癌（LCC，13.3%），而美国患者的肿瘤部位则是直肠癌（44.4%）、右半结肠癌（29.8%）和左半结肠癌（25.8%）。中国CRC患者男性比例更高（58.9%对52.4%，p＜0.001），II期CRC比例更高（49.8%对27.8%，p＜0.001），诊断时年龄更小（中位年龄64岁对66岁，p＜0.001）。中国直肠癌和左半结肠癌患者的根治性手术率较低（直肠癌：92.3%对93.9%，p＜0.001；左半结肠癌：88.9%对92.0%，p＜0.001）。中国CRC患者的辅助治疗率较低。中美两国CRC患者的5年总生存率分别为71.8%和78.2%（p＜0.001）。中国CRC的发病率正在上升。中美两国人群CRC的治疗和死亡率存在差异。与美国相比，中国的辅助治疗率和5年总生存率较低。
