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.	孙可欣, 郑荣寿, 张思维, 等. 2015年中国分地区恶性肿瘤发病和死亡分析. 中国肿瘤, 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.
6.	汪晓东, 朱佳怡, 李立. 数据库建设第十一部分: 结直肠癌随访的标签与结构化. 中国普外基础与临床杂志, 2021, 28(10): 1353-1359.
7.	汪晓东, 李立. 数据库建设第一部分: 个人数据的标签与结构化. 中国普外基础与临床杂志, 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.	杨小冬, 黄平, 王锋, 等. 结直肠癌患者预后相关因素分析. 江苏医药, 2010, 36(24): 2903-2906.
15.	卢晓华, 田红梅, 王孟娇, 等. 5 016例结直肠癌病例特征及预后分析. 华南预防医学, 2022, 48(6): 742-744, 748.
16.	邹雨恒, 廖伟豪, 刘莹, 等. 结直肠癌患者年龄对长期生存预后可能有影响: 基于DACCA数据库的真实世界分析. 中国普外基础与临床杂志, 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. 孙可欣, 郑荣寿, 张思维, 等. 2015年中国分地区恶性肿瘤发病和死亡分析. 中国肿瘤, 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.
6. 汪晓东, 朱佳怡, 李立. 数据库建设第十一部分: 结直肠癌随访的标签与结构化. 中国普外基础与临床杂志, 2021, 28(10): 1353-1359.
7. 汪晓东, 李立. 数据库建设第一部分: 个人数据的标签与结构化. 中国普外基础与临床杂志, 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. 杨小冬, 黄平, 王锋, 等. 结直肠癌患者预后相关因素分析. 江苏医药, 2010, 36(24): 2903-2906.
15. 卢晓华, 田红梅, 王孟娇, 等. 5 016例结直肠癌病例特征及预后分析. 华南预防医学, 2022, 48(6): 742-744, 748.
16. 邹雨恒, 廖伟豪, 刘莹, 等. 结直肠癌患者年龄对长期生存预后可能有影响: 基于DACCA数据库的真实世界分析. 中国普外基础与临床杂志, 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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