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Gu XF, Xu HF, Liu Y, Li L, Yu YQ, Zhang X, Wang XH, Wang WJ, Du LB, Duan SX, Cao HL, Zhao YQ, Liu YY, Huang JX, Cao J, Fan YP, Feng CY, Lian XM, Du JC, Rezhake R, Ma L, Qiao YL. Involvement in treatment decision-making and self-reported efficacy among patients with advanced colorectal cancer: a nationwide multi-center cross-sectional study. Front Oncol 2023; 13:1168078. [PMID: 37564928 PMCID: PMC10411882 DOI: 10.3389/fonc.2023.1168078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/22/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction This cross-sectional study evaluated the involvement of patients with advanced colorectal cancer (CRC) in treatment decision-making, assessed the treatment efficacy according to their self-reports, and investigated the influencing factors. Methods Patients with advanced CRC were recruited from 19 hospitals from March 2020 to March 2021 by a multi-stage multi-level sampling method. A self-designed questionnaire was used to collect demographic and clinical characteristics, involvement of CRC patients in treatment decision-making, treatment methods, and self-reported efficacy. Univariate and unordered multinomial logistic regression analyses were used to evaluate the factors affecting the involvement in treatment decision-making and self-reported efficacy. Results We enrolled 4533 patients with advanced CRC. The average age at diagnosis was 58.7 ± 11.8 years. For the treatment method, 32.4% of patients received surgery combined with chemotherapy, 13.1% of patients underwent surgery combined with chemotherapy and targeted therapy, and 9.7% of patients were treated with surgery alone. For treatment decision-making, 7.0% of patients were solely responsible for decision-making, 47.0% of patients shared treatment decision-making with family members, 19.0% of patients had family members solely responsible for treatment decision-making, and 27.0% of patients had their physicians solely responsible for treatment decision-making. Gender, age, education level, family income, marital status, treatment cost, hospital type, and treatment method were significantly associated with the involvement of patients in treatment decision-making. A total of 3824 patients submitted self-reported efficacy evaluations during treatment. The percentage of patients with good self-reported efficacy was 76.5% (for patients treated for the first time), 61.7% (for patients treated for the second time), and 43.2% (for patients treated after recurrence and metastasis), respectively. Occupation, education level, average annual family income, place of residence, time since cancer diagnosis, hospital type, clinical stage, targeted therapy, and involvement in treatment decision-making were the main influencing factors of self-reported efficacy of treatment. Discussion Conclusively, CRC patients are not highly dominant in treatment decision-making and more likely to make treatment decisions with their family and doctors. Timely and effective communication between doctors and patients can bolster patient involvement in treatment decision-making.
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Affiliation(s)
- Xiao-Fen Gu
- Department of Student Affairs, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Yin Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Yan-Qin Yu
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shuang-Xia Duan
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Yu-Qian Zhao
- Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastrodiges, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Xue-Mei Lian
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Remila Rezhake
- Department of Student Affairs, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - You-Lin Qiao
- Department of Student Affairs, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Jane Ling MY, Ahmad N, Aizuddin AN. Risk perception of non-communicable diseases: A systematic review on its assessment and associated factors. PLoS One 2023; 18:e0286518. [PMID: 37262079 DOI: 10.1371/journal.pone.0286518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/17/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The burden of non-communicable diseases (NCDs) is increasing. Risk perception of NCDs is an important factor towards the uptake of preventive health interventions. There are various questionnaires assessing risk perception of NCDs, but no internationally standardized questionnaire has been available. Identification of factors associated with risk perception of NCDs may facilitate the development of targeted interventions. This systematic review aims to identify available questionnaire assessing risk perception of NCDs and the factors associated with risk perception of NCDs. METHODS The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original article published in English between 2012 and 2021. Quality appraisal of the eligible articles was conducted using the Mixed Methods Appraisal Tool. Findings were synthesized using content analysis. RESULTS A total of 86 studies were included. We found a variety of questionnaires assessing risk perception of NCDs, with many differences in their development, domains, items and validity. We also identified several personal, sociopsychological and structural factors associated with risk perception of NCDs. LIMITATIONS Most of the included studies were of cross-sectional design, and therefore the quality of evidence was considered low and exhibit a high risk of bias. The role of publication bias within this systematic review should be acknowledged as we did not include grey literature. Additionally, language bias must be considered as we only included English-language publications. CONCLUSION Further development and testing of available questionnaire is warranted to ensure their robustness and validity in measuring risk perception of NCDs. All the identified factors deserve further exploration in longitudinal and experimental studies.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Xu HF, Gu XF, Wang XH, Wang WJ, Du LB, Duan SX, Liu Y, Zhang X, Zhao YQ, Ma L, Liu YY, Huang JX, Cao J, Fan YP, Li L, Feng CY, Lian XM, Du JC, Zhang JG, Yu YQ, Qiao YL. Knowledge and awareness of colorectal cancer risk factors, screening, and associated factors in advanced colorectal cancer patients: a multicenter cross-sectional study in China. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:354. [PMID: 35433933 PMCID: PMC9011206 DOI: 10.21037/atm-22-1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/06/2022]
Abstract
Background Colorectal cancer (CRC) is the 3rd most common malignancy globally, and its disease burden is increasing rapidly in China. But CRC patients' knowledge and awareness of CRC have not yet been examined, which could facilitate the identification of targeted population from public for intervention. Methods A nationwide multicenter cross-sectional survey was conducted in 19 tertiary hospitals (10 cancer hospitals and 9 general hospitals) from March 2020 to March 2021 in China. During study period, all Stage III and IV CRC patients were invited to complete a semi-structured survey that had been designed to collect information about their socio-demographic characteristics, and knowledge and awareness of CRC risk factors and screening. A multivariate logistic regression model was used to identify factors associated with their knowledge and awareness. Results In total, 4,589 advanced CRC patients were enrolled in this study, of whom, 46.2% were from tertiary cancer hospitals, and 59.5% were male. Patients had a mean age of 60.1±11.6 years. Before diagnosis, 65.1% of the patients had no related knowledge of the CRC risk factors, and 84.9% were unaware of the CRC screening-related information. Only 30.4% of patients had actively sought to acquire CRC-related knowledge before diagnosis. The 3 most common knowledge sources were relatives or friends who had been diagnosed with CRC (13.2%), popular science television/broadcast shows (12.9%), and community publicity and education (9.6%). Generally, knowledge and awareness were positively associated with better education level [odds ratios (ORs) ranged from 1.49 to 2.54, P<0.001], annual household income ranged from 50,000 Chinese Yuan (CNY) to 100,000 CNY (OR =1.32, P<0.001), being manual laborer (OR =1.25, P<0.001) and being white-collar worker (OR =1.47, P<0.001). Conclusions Advanced CRC patients' knowledge and awareness of CRC were severely limited before diagnosis. Thus, those who had limited knowledge and awareness should has a priority for intervention.
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Affiliation(s)
- Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shuang-Xia Duan
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Yin Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yu-Qian Zhao
- Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Xue-Mei Lian
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Jian-Gong Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Yan-Qin Yu
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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