Impact of literacy on long-term prognosis in colorectal cancer patients: a real-world study based on DACCA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YE Zi ^1,2 , ZHOU Fanlin ² , RAO Jiayuan ² , SU Yu ² , YU Kaicong ² , WANG Shunyao ² ,  WANG Xiaodong ^1,2 , HUANG Mingjun ³

1. Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
3. Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WANG Xiaodong, Email: wangxiaodong@wchscu.cn

Keywords：

colorectal cancer; literacy; overall survival; disease-specific survival; pathological TNM staging

DOI：

10.7507/1007-9424.202401006

Video：

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Objective To analyze the relation between the literacy and prognosis in the patients with colorectal cancer (CRC) in the current version of the Database from Colorectal Cancer of West China (DACCA). Methods The version of DACCA selected for this data analysis was updated on September 12, 2022. The data items analyzed included age, gender, literacy, tumour site, nature of tumour, pathological TNM (pTNM) stage, survival status, and survival time. The overall survival and disease-specific survival of the CRC patients with different literacy (illiteracy, primary, secondary, and tertiary educations) after radical resection were compared, and then which were analyzed in the patients with different pTNM stages. Results A total of 3 692 data eligible for the study were screened, of which 202 were illiteracy, 1 054 were primary education, 1 809 were secondary education, and 627 were tertiary education; And there were 13 of stage 0, 406 of stage Ⅰ, 1 193 of stage Ⅱ, 1 139 of stage Ⅲ, and 941 of stage Ⅳ. The differences in the comparison of the pTNM stage and the nature of the tumour among the patients with the four levels of literacy were not statistically significant (P>0.05), while the differences in the comparison of the gender, age, and tumour site were statistically significant (P<0.001). The overall survival and disease-specific survival curves of the CRC patients with different literacy had no statistical differences (χ²=1.982, P=0.576; χ²=2.618, P=0.454), and the stratified overall survival curves had no statistical differences among the patients with pTNM stages Ⅰ to Ⅳ (stage Ⅰ: χ²=1.361, P=0.715; stage Ⅱ: χ²=3.507, P=0.320; stage Ⅲ: χ²=3.144, P=0.370; stage Ⅳ: χ²=4.993, P=0.172), and the stratified disease-specific survival curves had no statistical differences (stage Ⅰ: χ²=0.723, P=0.868; stage Ⅱ: χ²=3.295, P=0.348; stage Ⅲ: χ²=4.767, P=0.190; stage Ⅳ: χ²=6.177, P=0.103). Conclusions The results of this study based on real-world big data analysis suggests that the differences of overall survival and disease-specific survival of CRC patients with different literacy levels (illiterate, primary, secondary, and tertiary education) are not statistically significant, and the results of stratified analysis based on pTNM staging are consistent with this. In the future, limitations of this study can be excluded and further analysis can be conducted by combining treatment details or expanding sample data to seek more realistic results.

Citation： YE Zi, ZHOU Fanlin, RAO Jiayuan, SU Yu, YU Kaicong, WANG Shunyao, WANG Xiaodong, HUANG Mingjun. Impact of literacy on long-term prognosis in colorectal cancer patients: a real-world study based on DACCA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(4): 427-432. doi: 10.7507/1007-9424.202401006 Copy

1.	汪曉東, 劉健博, 李立. 數據庫建設第五部分: 結直腸癌的腫瘤特征—模塊的設計(一). 中國普外基礎與臨床雜志, 2020, 27(3): 345-349.
2.	汪曉東, 劉健博, 李立. 數據庫建設第五部分·結直腸癌的腫瘤特征—模塊的設計(二). 中國普外基礎與臨床雜志, 2020, 27(4): 483-488.
3.	孫可欣, 鄭榮壽, 張思維, 等. 2015年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2019, 28(1): 1-11.
4.	Egeberg R, Halkjaer J, Rottmann N, et al. Social inequality and incidence of and survival from cancers of the colon and rectum in a population-based study in Denmark, 1994–2003. Eur J Cancer, 2008, 44(14): 1978-1988.
5.	汪曉東, 劉健博, 李立. 數據庫建設第六部分: 結直腸癌分期的標簽與結構化. 中國普外基礎與臨床雜志, 2020, 27(7): 873-879.
6.	汪曉東, 朱佳怡, 李立. 數據庫建設第十一部分: 結直腸癌隨訪的標簽與結構化. 中國普外基礎與臨床雜志, 2021, 28(10): 1353-1359.
7.	汪曉東, 李立. 數據庫建設第一部分: 個人數據的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(3): 335-342.
8.	van Loon AJ, van den Brandt PA, Golbohm RA. Socioeconomic status and colon cancer incidence: a prospective cohort study. Br J Cancer, 1995, 71(4): 882-887.
9.	Shaw C, Blakely T, Sarfati D, et al. Trends in colorectal cancer mortality by ethnicity and socio-economic position in New Zealand, 1981-99: one country, many stories. Aust N Z J Public Health, 2006, 30(1): 64-70.
10.	Du XL, Fang S, Vernon SW, et al. Racial disparities and socioeconomic status in association with survival in a large population-based cohort of elderly patients with colon cancer. Cancer, 2007, 110(3): 660-669.
11.	Kim D, Masyn KE, Kawachi I, et al. Neighborhood socioeconomic status and behavioral pathways to risks of colon and rectal cancer in women. Cancer, 2010, 116(17): 4187-4196.
12.	Byers TE, Wolf HJ, Bauer KR, et al. The impact of socioeconomic status on survival after cancer in the United States : findings from the National Program of Cancer Registries Patterns of Care Study. Cancer, 2008, 113(3): 582-591.
13.	Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet, 2014, 383(9927): 1490-1502.
14.	楊小冬, 黃平, 王鋒, 等. 結直腸癌患者預后相關因素分析. 江蘇醫藥, 2010, 36(24): 2903-2906.
15.	盧曉華, 田紅梅, 王孟嬌, 等. 5 016例結直腸癌病例特征及預后分析. 華南預防醫學, 2022, 48(6): 742-744, 748.
16.	鄒雨恒, 廖偉豪, 劉瑩, 等. 結直腸癌患者年齡對長期生存預后可能有影響: 基于DACCA數據庫的真實世界分析. 中國普外基礎與臨床雜志, 2022, 29(6): 795-802.
17.	Hines R, Markossian T, Johnson A, et al. Geographic residency status and census tract socioeconomic status as determinants of colorectal cancer outcomes. Am J Public Health, 2014, 104(3): e63-e71. doi: 10.2105/AJPH.2013.301572.
18.	Kelsall HL, Baglietto L, Muller D, et al. The effect of socioeconomic status on survival from colorectal cancer in the Melbourne Collaborative Cohort Study. Soc Sci Med, 2009, 68(2): 290-297.

1. 汪曉東, 劉健博, 李立. 數據庫建設第五部分: 結直腸癌的腫瘤特征—模塊的設計(一). 中國普外基礎與臨床雜志, 2020, 27(3): 345-349.
2. 汪曉東, 劉健博, 李立. 數據庫建設第五部分·結直腸癌的腫瘤特征—模塊的設計(二). 中國普外基礎與臨床雜志, 2020, 27(4): 483-488.
3. 孫可欣, 鄭榮壽, 張思維, 等. 2015年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2019, 28(1): 1-11.
4. Egeberg R, Halkjaer J, Rottmann N, et al. Social inequality and incidence of and survival from cancers of the colon and rectum in a population-based study in Denmark, 1994–2003. Eur J Cancer, 2008, 44(14): 1978-1988.
5. 汪曉東, 劉健博, 李立. 數據庫建設第六部分: 結直腸癌分期的標簽與結構化. 中國普外基礎與臨床雜志, 2020, 27(7): 873-879.
6. 汪曉東, 朱佳怡, 李立. 數據庫建設第十一部分: 結直腸癌隨訪的標簽與結構化. 中國普外基礎與臨床雜志, 2021, 28(10): 1353-1359.
7. 汪曉東, 李立. 數據庫建設第一部分: 個人數據的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(3): 335-342.
8. van Loon AJ, van den Brandt PA, Golbohm RA. Socioeconomic status and colon cancer incidence: a prospective cohort study. Br J Cancer, 1995, 71(4): 882-887.
9. Shaw C, Blakely T, Sarfati D, et al. Trends in colorectal cancer mortality by ethnicity and socio-economic position in New Zealand, 1981-99: one country, many stories. Aust N Z J Public Health, 2006, 30(1): 64-70.
10. Du XL, Fang S, Vernon SW, et al. Racial disparities and socioeconomic status in association with survival in a large population-based cohort of elderly patients with colon cancer. Cancer, 2007, 110(3): 660-669.
11. Kim D, Masyn KE, Kawachi I, et al. Neighborhood socioeconomic status and behavioral pathways to risks of colon and rectal cancer in women. Cancer, 2010, 116(17): 4187-4196.
12. Byers TE, Wolf HJ, Bauer KR, et al. The impact of socioeconomic status on survival after cancer in the United States : findings from the National Program of Cancer Registries Patterns of Care Study. Cancer, 2008, 113(3): 582-591.
13. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet, 2014, 383(9927): 1490-1502.
14. 楊小冬, 黃平, 王鋒, 等. 結直腸癌患者預后相關因素分析. 江蘇醫藥, 2010, 36(24): 2903-2906.
15. 盧曉華, 田紅梅, 王孟嬌, 等. 5 016例結直腸癌病例特征及預后分析. 華南預防醫學, 2022, 48(6): 742-744, 748.
16. 鄒雨恒, 廖偉豪, 劉瑩, 等. 結直腸癌患者年齡對長期生存預后可能有影響: 基于DACCA數據庫的真實世界分析. 中國普外基礎與臨床雜志, 2022, 29(6): 795-802.
17. Hines R, Markossian T, Johnson A, et al. Geographic residency status and census tract socioeconomic status as determinants of colorectal cancer outcomes. Am J Public Health, 2014, 104(3): e63-e71. doi: 10.2105/AJPH.2013.301572.
18. Kelsall HL, Baglietto L, Muller D, et al. The effect of socioeconomic status on survival from colorectal cancer in the Melbourne Collaborative Cohort Study. Soc Sci Med, 2009, 68(2): 290-297.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Impact of literacy on long-term prognosis in colorectal cancer patients: a real-world study based on DACCA

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