DOI QR코드

DOI QR Code

Colorectal Cancer Concealment Predicts a Poor Survival: A Retrospective Study

  • Li, Xiao-Pan (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Xie, Zhen-Yu (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Fu, Yi-Fei (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Yang, Chen (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Hao, Li-Peng (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Yang, Li-Ming (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Zhang, Mei-Yu (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Li, Xiao-Li (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Feng, Li-Li (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Yan, Bei (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention) ;
  • Sun, Qiao (Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention)
  • Published : 2013.07.30

Abstract

Objectives: Understanding the situation of cancer awareness which doctors give to patients might lead to prognostic prediction in cases of of colorectal cancer (CRC). Methods: Subsets of 10,779 CRC patients were used to screen the risk factors from the Cancer Registry in Pudong New Area in cancer awareness, age, TNM stage, and gender. Survival of the patients was calculated by the Kaplan-Meier method and assessed by Cox regression analysis. The views of cancer awareness in doctors and patients were surveyed by telephone or household. Results: After a median observation time of 1,616 days (ranging from 0 to 4,083 days) of 10,779 available patients, 2,596 of the 4,561 patients with cancer awareness survived, whereas 2,258 of the 5,469 patients without cancer awareness and 406 of the 749 patients without information on cancer awareness died of the disease. All-cause and cancer-specific survival were poorer for the patients without cancer awareness than those with (P < 0.001 for each, log-rank test). Cox multivariate regression analysis showed that cancer concealment cases had significantly lower cancer-specific survival (hazard ratio (HR) = 1.299; 95 % confidence interval (CI): 1.200-1.407)and all-cause survival (HR = 1.324; 95 % CI: 1.227-1.428). Furthermore, attitudes of cancer awareness between doctors and patients were significantly different (P < 0.001). Conclusion: Cancer concealment, not only late-stage tumor and age, is associated with a poor survival of CRC patients.

Keywords

Colorectal cancer;awareness;risk factors;survival

References

  1. Anderson AS, Caswell S, Wells M, et al (2013). Obesity and lifestyle advice in colorectal cancer survivors - How well are clinicians prepared? Colorectal Dis (Epub ahead of print).
  2. Ballard-Barbash R, Friedenreich CM, Courneya KS, et al (2012). Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst, 104, 815-40. https://doi.org/10.1093/jnci/djs207
  3. Bennett JA, Winters-Stone KM, Dobek J, et al (2013). Frailty in older breast cancer survivors: age, prevalence, and associated factors. Oncol Nurs Forum, 40, E126-34. https://doi.org/10.1188/13.ONF.E126-E134
  4. Campbell PT, Jacobs ET, Ulrich CM, et al (2010). Case-control study of overweight, obesity, and colorectal cancer risk, overall and by tumor microsatellite instability status. J Natl Cancer Inst, 102, 391-400. https://doi.org/10.1093/jnci/djq011
  5. Ceilleachair AO, Costello L, Finn C, et al (2012). Inter-relationships between the economic and emotional consequences of colorectal cancer for patients and their families: a qualitative study. BMC Gastroenterol, 12, 62. https://doi.org/10.1186/1471-230X-12-62
  6. Center MM, Jemal A, Smith RA, et al (2009a). Worldwide variations in colorectal cancer. CA Cancer J Clin, 59, 366-78. https://doi.org/10.3322/caac.20038
  7. Center MM, Jemal A, and Ward E (2009b). International trends in colorectal cancer incidence rates. Cancer Epidemiol Biomarkers Prev, 18, 1688-94. https://doi.org/10.1158/1055-9965.EPI-09-0090
  8. Chao A, Connell CJ, Jacobs EJ, et al (2004). Amount, type, and timing of recreational physical activity in relation to colon and rectal cancer in older adults: the Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev, 13, 2187-95.
  9. DeSantis C, Siegel R, Bandi P, et al (2011). Breast cancer statistics, 2011. CA Cancer J Clin, 61, 409-18.
  10. Fedor D, Johnson WR, Singhal S (2013). Local recurrence following lung cancer surgery: Incidence, risk factors, and outcomes. Surg Oncol (Epub ahead of print).
  11. Howlader N, Ries LA, Mariotto AB, et al (2010). Improved estimates of cancer-specific survival rates from populationbased data. J Natl Cancer Inst, 102, 1584-98. https://doi.org/10.1093/jnci/djq366
  12. Hung HC, Chien TW, Tsay SL, et al (2013). Patient and Clinical Variables Account for Changes in Health- related Quality of Life and Symptom Burden as Treatment Outcomes in Colorectal Cancer: A Longitudinal Study. Asian Pac J Cancer Prev, 14, 1905-09. https://doi.org/10.7314/APJCP.2013.14.3.1905
  13. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  14. Ketabi Z, Mosgaard BJ, Gerdes AM, et al (2012). Awareness of endometrial cancer risk and compliance with screening in hereditary nonpolyposis colorectal cancer. Obstet Gynecol, 120, 1005-12.
  15. Koo JH, Leong RW, Ching J, et al (2012). Knowledge of, attitudes toward, and barriers to participation of colorectal cancer screening tests in the Asia-Pacific region: a multicenter study. Gastrointest Endosc, 76, 126-35. https://doi.org/10.1016/j.gie.2012.03.168
  16. Kuiper JG., Phipps AI, Neuhouser ML, et al (2012). Recreational physical activity, body mass index, and survival in women with colorectal cancer. Cancer Causes Control, 23, 1939-48. https://doi.org/10.1007/s10552-012-0071-2
  17. Lin DW, Porter M, Montgomery B (2009). Treatment and survival outcomes in young men diagnosed with prostate cancer: a Population-based Cohort Study. Cancer, 115, 2863-71. https://doi.org/10.1002/cncr.24324
  18. Li X, Tan X, Yu Y, et al (2011). D9S168 microsatellite alteration predicts a poor prognosis in patients with clear cell renal cell carcinoma and correlates with the down-regulation of protein tyrosine phosphatase receptor delta. Cancer, 117, 4201-11. https://doi.org/10.1002/cncr.26028
  19. Mai PL, Sullivan-Halley J, Ursin G, et al (2007). Physical activity and colon cancer risk among women in the California Teachers Study. Cancer Epidemiol Biomarkers Prev, 16, 517-25. https://doi.org/10.1158/1055-9965.EPI-06-0747
  20. Maringe C, Walters S, Rachet B, et al (2013). Stage at diagnosis and colorectal cancer survival in six high-income countries: A population-based study of patients diagnosed during 2000-2007. Acta Oncol, 52, 919-32. https://doi.org/10.3109/0284186X.2013.764008
  21. Meyerhardt JA, Giovannucci EL, Holmes MD, et al (2006a). Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol, 24, 3527-34. https://doi.org/10.1200/JCO.2006.06.0855
  22. Meyerhardt JA, Heseltine D, Niedzwiecki D, et al (2006b). Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol, 24, 3535-41. https://doi.org/10.1200/JCO.2006.06.0863
  23. Meyerhardt JA, Ogino S, Kirkner GJ, et al (2009). Interaction of molecular markers and physical activity on mortality in patients with colon cancer. Clin Cancer Res, 15, 5931-36. https://doi.org/10.1158/1078-0432.CCR-09-0496
  24. Papanikolaou IS, Sioulas AD, Kalimeris S, et al (2012). Awareness and attitudes of Greek medical students on colorectal cancer screening. World J Gastrointest Endosc, 4, 513-7. https://doi.org/10.4253/wjge.v4.i11.513
  25. Roth AD, Delorenzi M, Tejpar S, et al (2012). Integrated analysis of molecular and clinical prognostic factors in stage II/III colon cancer. J Natl Cancer Inst, 104, 1635-46. https://doi.org/10.1093/jnci/djs427
  26. Vostakolaei FA, Broeders MJ, Rostami N, et al (2012). Age at diagnosis and breast cancer survival in iran. Int J Breast Cancer, 2012, 517976.
  27. Wang DC, Guo CB, Peng X, et al (2011). Is therapeutic non-disclosure still possible? A study on the awareness of cancer diagnosis in China. Support Care Cancer, 19, 1191-5. https://doi.org/10.1007/s00520-010-0937-3
  28. Wang DC, Peng X, Guo CB, et al (2013). When clinicians telling the truth is de facto discouraged, what is the family's attitude towards disclosing to a relative their cancer diagnosis? Support Care Cancer, 21, 1089-95. https://doi.org/10.1007/s00520-012-1629-y

Cited by

  1. Survival of Colorectal Cancer Patients in the Presence of Competing-Risk vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6253
  2. New Technique of Intracorporeal Anastomosis and Transvaginal Specimen Extraction for Laparoscopic Sigmoid Colectomy vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6733
  3. Discordance between Perceived and Actual Cancer Stage among Cancer Patients in Korea: A Nationwide Survey vol.9, pp.5, 2014, https://doi.org/10.1371/journal.pone.0090483
  4. Survival of Colorectal Cancer in the Presence of Competing-Risks - Modeling by Weibull Distribution vol.17, pp.3, 2016, https://doi.org/10.7314/APJCP.2016.17.3.1193