Liu Hongwei, Jia Ziyao, Xu Huifang, Wang Xiaoyang, Wang Hong, Kang Ruihua, Chen Qiong, Guo Xiaoli, Qie Ranran, Zhao Mengfei, Cheng Cheng, Zheng Liyang, Liu Shuzheng, Liu Yin, Zhang Shaokai
Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China.
The First Clinical School of Medicine, Zhengzhou University, Zhengzhou, 450008, China.
BMC Cancer. 2025 Aug 1;25(1):1256. doi: 10.1186/s12885-025-14713-9.
Colorectal cancer (CRC) is prevalent in China, but many features of CRC patients remain to be better characterized. We aimed to describe the characteristics of clinical epidemiology in CRC patients in China and to evaluate the changes in health-related quality of life (HRQOL) before and after treatment.
A hospital-based survey was conducted among CRC patients from 2020 to 2021, covering 14 cities in China. Data on demographic and clinical characteristics, disease knowledge, medical service utilization, medical expenditure, and HRQOL before and after treatment were surveyed. The multivariable regressions and structural equation model (SEM) were used to assess the association between characteristics and HRQOL.
In the survey of 4589 patients, nearly 80% were diagnosed at an age older than 50, with 59.5% being men and 54.5% having rectal cancer. Approximately 35.2% were diagnosed at stage IV and 37.5% had metastases. Prior to diagnosis, only 2.6% of patients had a colonoscopy screening, with the primary barrier being unawareness. After treatment, there was a significant decline in the overall HRQOL scores (66.98 vs. 65.39, P < 0.001) and a significant association between patients' awareness of CRC treatment and higher HRQOL changes (beta: 0.98, 95% CI 0.39-1.57; P = 0.001). The SEM model showed good model fit, revealing that awareness of CRC treatment was significantly associated with changes in HRQOL (beta: 0.06, 95% CI 0.04-0.09; P = 0.009).
Our study highlighted a low CRC screening rate in China, largely due to limited public awareness. After treatment, HRQOL declined, and treatment awareness was significantly associated with this change.
结直肠癌（CRC）在中国很常见，但CRC患者的许多特征仍有待更深入地描述。我们旨在描述中国CRC患者的临床流行病学特征，并评估治疗前后健康相关生活质量（HRQOL）的变化。
2020年至2021年对中国14个城市的CRC患者进行了一项基于医院的调查。调查了人口统计学和临床特征、疾病知识、医疗服务利用、医疗支出以及治疗前后的HRQOL数据。使用多变量回归和结构方程模型（SEM）来评估特征与HRQOL之间的关联。
在对4589名患者的调查中，近80%在50岁以上被诊断，59.5%为男性，54.5%患有直肠癌。约35.2%在IV期被诊断，37.5%有转移。在诊断前，只有2.6%的患者进行了结肠镜筛查，主要障碍是缺乏认识。治疗后，总体HRQOL评分显著下降（66.98对65.39，P<0.001），患者对CRC治疗的认识与更高的HRQOL变化之间存在显著关联（β：0.98，95%CI 0.39-1.57；P=0.001）。SEM模型显示出良好的模型拟合，表明对CRC治疗的认识与HRQOL的变化显著相关（β：0.06，95%CI 0.04-0.09；P=0.009）。
我们的研究强调中国CRC筛查率较低，主要原因是公众意识有限。治疗后，HRQOL下降，治疗意识与这种变化显著相关。
