The change in epidemiological characteristics and utilization of health services for the diagnosis and treatment of colorectal cancer: A hospital-based retrospective survey.

BACKGROUND: The incidence, mortality, epidemiological characteristics, and health utilization for the diagnosis and treatment of colorectal cancer in China have shown an upward trend over time, with substantial nationwide regional variation. We aimed to observe the shift in demographic and clinical characteristics and medical utilization for the diagnosis and treatment of colorectal cancer in Guangxi from 2005 to 2014. METHODS: This study was a hospital-based retrospective survey. We enrolled patients with primary colorectal cancer in a tertiary A specialized cancer hospital diagnosed between 2005 and 2014. Patients' data were collected by trained investigators via the electronic hospital medical records. All data were calculated and analyzed using the Statistical Package for the Social Sciences version 20 statistical software. RESULTS: Data of 1065 primary colorectal cancer patients were collected. The mean age at diagnosis was 57.33-years, and the male-to-female ratio was 1.51. The proportion of overweight/obese patients ranged from 4.95% to 23.76% between 2005 and 2014, with an upward trend. The percentage of patients with tobacco consumption increased from 4.00% to 25.45% between 2005 and 2014, and the proportion of patients undergoing CT increased from 12% to 90%; for MRI, from 0% to 25%; and for colonoscopy, from 18% to 74%. The positive rates of serum carcinoembryonic antigen with or without metastasis were 70.83% and 41.5% (p < 0.001). The positive rates of carcinoembryonic antigen and carbohydrate antigen 19-9 were positively correlated with stages at diagnosis (r = 0.31, 95% Confidence Interval: 0.18-0.34, p < 0.001) and (r = 0.35, 95% Confidence Interval: 0.21-0.47, p < 0.001), respectively. CONCLUSIONS: The rising percentage of overweight/obese and smokers among farmers poses challenges for the prevention, control, and treatment of colorectal cancer in Guangxi. The level of serum carcinoembryonic antigen before therapy can provide information for colorectal cancer with asymptomatic metastatic disease and advanced stage.