Colorectal Cancer Concealment Predicts a Poor Survival: A Retrospective Study

Objectives: Understanding the situation of cancer awareness which doctors give to patients might lead toprognostic prediction in cases of of colorectal cancer (CRC).
Methods: Subsets of 10,779 CRC patients were usedto 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 regressionanalysis. 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 ofthe 4,561 patients with cancer awareness survived, whereas 2,258 of the 5,469 patients without cancer awarenessand 406 of the 749 patients without information on cancer awareness died of the disease. All-cause and cancerspecificsurvival were poorer for the patients without cancer awareness than those with (P < 0.001 for each, logranktest). Cox multivariate regression analysis showed that cancer concealment cases had significantly lowercancer-specific survival (hazard ratio (HR) = 1.299; 95 % confidence interval (CI): 1.200-1.407)and all-causesurvival (HR = 1.324; 95 % CI: 1.227-1.428). Furthermore, attitudes of cancer awareness between doctors andpatients were significantly different (P < 0.001).
Conclusion: Cancer concealment, not only late-stage tumor andage, is associated with a poor survival of CRC patients.