Ng Shu Kay, Baade Peter, Wittert Gary, Lam Alfred K, Zhang Ping, Henderson Saras, Goodwin Belinda, Aitken Joanne F
School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia.
Cancer Council Queensland, Fortitude Valley, QLD 4006, Australia.
J Public Health (Oxf). 2025 May 29;47(2):132-143. doi: 10.1093/pubmed/fdaf012.
Women have better survival than men patients with colorectal cancer (CRC), but the extent to which this is due to multimorbidity is unclear.
A population-based study of 1843 patients diagnosed with CRC in Australia. Data included patient's demographics, multimorbidity, tumour histology, cancer stage, and treatment. We estimated the risks of all-cause mortality and cause-specific mortality due to cancer or non-cancer causes.
Men had lower survival than women (P ≤ 0.010) amongst those diagnosed at Stages I-III (15-year survival: 56.0% vs 68.0%, 48.5% vs 60.7%, 34.8% vs 47.5%, respectively), excepting Stage IV (14.4% vs 12.6%; P = 0.18). Married men exhibit better survival than those who were never married (P = 0.006). Heart attacks (9.9% vs 4.3%, P < 0.001) and emphysema (4.8% vs 2.1%, P = 0.004) were more prevalent in men than women. Comorbid stroke and high cholesterol (adjusted hazard ratio, AHR = 2.22, 95% confidence interval, CI = 1.17-4.21, P = 0.014) and leukaemia (AHR = 6.36, 95% CI = 3.08-13.1, P < 0.001) increased the risk of cancer death for men only. For women, diabetes increased the risk of all-cause death (AHR = 1.38, 95% CI = 1.02-1.86, P = 0.039) and high blood pressure increased the risk of death due to non-cancer causes (AHR = 2.00, 95% CI = 1.36-2.94, P < 0.001).
Separate models of CRC care are needed for men and women with consideration of multimorbidity and social factors.
在结直肠癌（CRC）患者中，女性的生存率高于男性，但这种情况在多大程度上归因于多种疾病共存尚不清楚。
对澳大利亚1843例诊断为CRC的患者进行基于人群的研究。数据包括患者的人口统计学特征、多种疾病共存情况、肿瘤组织学、癌症分期和治疗情况。我们估计了全因死亡率以及因癌症或非癌症原因导致的特定病因死亡率的风险。
在I - III期诊断的患者中，男性的生存率低于女性（P≤0.010）（15年生存率：分别为56.0%对68.0%、48.5%对60.7%、34.8%对47.5%），IV期除外（14.4%对12.6%；P = 0.18）。已婚男性的生存率高于从未结婚的男性（P = 0.006）。男性中心脏病发作（9.9%对4.3%，P < 0.001）和肺气肿（4.8%对2.1%，P = 0.004）比女性更常见。合并中风和高胆固醇（调整后风险比，AHR = 2.22，95%置信区间，CI = 1.17 - 4.21，P = 0.014）以及白血病（AHR = 6.36，95%CI = 3.08 - 13.1，P < 0.001）仅增加男性癌症死亡风险。对于女性，糖尿病增加全因死亡风险（AHR = 1.38，95%CI = 1.02 - 1.86，P = 0.039），高血压增加非癌症原因导致的死亡风险（AHR = 2.00，95%CI = 1.36 - 2.94，P < 0.001）。
需要针对男性和女性CRC患者分别制定考虑多种疾病共存情况和社会因素的治疗模式。
