Relationship between educational level and oncological characteristics of colorectal cancer patients: A real<b>-</b>world study based on DACCA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DU Yiling ^1,2 , ZHOU Fanlin ^1,2 , WANG Shunyao ^1,2 ,  WANG Xiaodong ¹ , LI Li ^1,3

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. Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Xiaodong, Email: wangxiaodong@wchscu.cn

Keywords：

colorectal cancer; oncological characteristics; database from colorectal cancer; educational level

DOI：

10.7507/1007-9424.202310033

Video：

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Objective To analyze the relationship between educational level and oncological characteristics of colorectal patients served by Sichuan University West China Hospital in the current version of the Database from Colorectal Cancer (DACCA). Methods The DACCA version selected for this data analysis was the updated version on June 29, 2022. The data items analyzed included: educational level, precancerous lesions, family history of cancer, tumor location, tumor orientation, tumor pathology, tumor morphology, tumor differentiation and preoperative TNM staging. According to Article 17 of the Education Law of the People’s Republic of China, the educational level of the research subjects was divided into four categories: illiteracy group, the primary educated group (elementary school), the secondary educated group (middle school, high school, vocational school and technical school), and the higher educated group (university, higher vocational school, junior college and above). Results The DACCA database was filtered by conditions to obtain 5 512 valid data. The data analysis results showed that there were statistically significant differences in the composition ratios of precancerous lesions (χ²=27.398, P<0.001), tumor site (χ²=42.610, P<0.001) and tumor orientation (χ²=18.967, P=0.025) among the different education groups, and there were not statistically significant differences in the composition ratios of family history of cancer in oneself (χ²=9.345, P=0.133) or in the family (χ²=4.310, P=0.635), tumor pathological properties (χ²=27.027, P=0.202), tumor morphology (χ²=16.283, P=0.061), tumor differentiation degree (H=3.672, P=0.299) and the TNM staging of tumors before operation (H=0.156, P=0.984) among the different education groups. Conclusions Data analysis in DACCA reveal multiple associations between educational level and oncological characteristics of colorectal cancer patients. The education level of patients has a certain reference value in the investigation of various precancerous lesions. With the increase of education level, the proportion of tumors located in the rectum gradually decreases, and the proportion located in the colon gradually increases, and education level may affect treatment and prognosis by influencing preoperative tumor characteristics.

Citation： DU Yiling, ZHOU Fanlin, WANG Shunyao, WANG Xiaodong, LI Li. Relationship between educational level and oncological characteristics of colorectal cancer patients: A real-world study based on DACCA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(12): 1431-1438. doi: 10.7507/1007-9424.202310033 Copy

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2.	汪晓东, 刘健博, 李立. 数据库建设第五部分·结直肠癌的肿瘤特征—模块的设计(二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
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6.	汪晓东, 刘健博, 李立. 数据库建设第六部分: 结直肠癌分期的标签与结构化. 中国普外基础与临床杂志, 2020, 27(7): 873-879.
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12.	Imad FE, Drissi H, Tawfiq N, et al. Influence of socio-economic factors and education level on colorectal cancer in the Moroccan population. Pan Afr Med J, 2019, 34: 209.
13.	Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond), 2021, 41(10): 1037-1048.
14.	Li N, Lu B, Luo C, et al. Incidence, mortality, survival, risk factor and screening of colorectal cancer: A comparison among China, Europe, and Northern America. Cancer Lett, 2021, 522: 255-268.
15.	Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl), 2022, 135(5): 584-590.
16.	Cedric Y, Guy-Armand GN, Nadia NAC, et al. Epidemiology of schistosomiasis in the town of Manjo, littoral-Region, Cameroon. Parasite Epidemiol Control, 2023, 22: e00319.
17.	陈艳艳, 蔡顺祥, 利国, 等. 湖北省血吸虫病确诊病例流行病学调查. 中国血吸虫病防治杂志, 2016, 28(4): 358-364.
18.	Brooke HL, Talbäck M, Martling A, et al. Socioeconomic position and incidence of colorectal cancer in the Swedish population. Cancer Epidemiol, 2016, 40: 188-195.
19.	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. doi:10.1002/cncr.25195.
20.	Wakai K, Hirose K, Matsuo K, et al. Dietary risk factors for colon and rectal cancers: a comparative case-control study. J Epidemiol. 2006;16(3): 125-135. doi:10.2188/jea.16.125.
21.	Chai X, Li Y, Yin Z, et al. Association of Meat Subtypes With Colorectal Polyp Prevalence: Finding From the Lanxi Pre-colorectal Cancer Cohort in China. Front Nutr. 2022;9: 833571. Published 2022 Mar 18. doi:10.3389/fnut.2022.833571.

1. 汪晓东, 刘健博, 李立. 数据库建设第五部分: 结直肠癌的肿瘤特征—模块的设计(一). 中国普外基础与临床杂志, 2020, 27(3): 345-349.
2. 汪晓东, 刘健博, 李立. 数据库建设第五部分·结直肠癌的肿瘤特征—模块的设计(二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
3. 魏志敏, 蒋栋铭, 赵沛, 等. 2004—2018年中国大陆地区城乡居民结直肠癌死亡趋势分析. 中国癌症防治杂志, 2021, 13(5): 447-51.
4. Wernly S, Semmler G, Schaffler-Schaden D, et al. The association between educational status and colorectal neoplasia: results from a screening cohort. Int J Colorectal Dis, 2023, 38(1): 91.
5. Savijärvi S, Seppä K, Malila N, et al. Trends of colorectal cancer incidence by education and socioeconomic status in Finland. Acta Oncol, 2019, 58(11): 1557-1563.
6. 汪晓东, 刘健博, 李立. 数据库建设第六部分: 结直肠癌分期的标签与结构化. 中国普外基础与临床杂志, 2020, 27(7): 873-879.
7. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
8. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2022. CA Cancer J Clin, 2022, 72(1): 7-33.
9. Antunes L, Mendonça D, Bento MJ, et al. No inequalities in survival from colorectal cancer by education and socioeconomic deprivation—a population-based study in the North Region of Portugal, 2000-2002. BMC Cancer, 2016, 16: 608.
10. Cavalli-Björkman N, Lambe M, Eaker S, et al. Differences according to educational level in the management and survival of colorectal cancer in Sweden. Eur J Cancer, 2011, 47(9): 1398-1406.
11. Chen H, Li N, Ren J, et al. Participation and yield of a population-based colorectal cancer screening programme in China. Gut, 2019, 68(8): 1450-1457.
12. Imad FE, Drissi H, Tawfiq N, et al. Influence of socio-economic factors and education level on colorectal cancer in the Moroccan population. Pan Afr Med J, 2019, 34: 209.
13. Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond), 2021, 41(10): 1037-1048.
14. Li N, Lu B, Luo C, et al. Incidence, mortality, survival, risk factor and screening of colorectal cancer: A comparison among China, Europe, and Northern America. Cancer Lett, 2021, 522: 255-268.
15. Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl), 2022, 135(5): 584-590.
16. Cedric Y, Guy-Armand GN, Nadia NAC, et al. Epidemiology of schistosomiasis in the town of Manjo, littoral-Region, Cameroon. Parasite Epidemiol Control, 2023, 22: e00319.
17. 陈艳艳, 蔡顺祥, 利国, 等. 湖北省血吸虫病确诊病例流行病学调查. 中国血吸虫病防治杂志, 2016, 28(4): 358-364.
18. Brooke HL, Talbäck M, Martling A, et al. Socioeconomic position and incidence of colorectal cancer in the Swedish population. Cancer Epidemiol, 2016, 40: 188-195.
19. 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. doi:10.1002/cncr.25195.
20. Wakai K, Hirose K, Matsuo K, et al. Dietary risk factors for colon and rectal cancers: a comparative case-control study. J Epidemiol. 2006;16(3): 125-135. doi:10.2188/jea.16.125.
21. Chai X, Li Y, Yin Z, et al. Association of Meat Subtypes With Colorectal Polyp Prevalence: Finding From the Lanxi Pre-colorectal Cancer Cohort in China. Front Nutr. 2022;9: 833571. Published 2022 Mar 18. doi:10.3389/fnut.2022.833571.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Relationship between educational level and oncological characteristics of colorectal cancer patients: A real-world study based on DACCA

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