Involvement in treatment decision-making and self-reported efficacy among patients with advanced colorectal cancer: a nationwide multi-center cross-sectional study

Xiao Fen Gu, Hui Fang Xu, Yin Liu, Li Li, Yan Qin Yu, Xi Zhang, Xiao Hui Wang, Wen Jun Wang, Ling Bin Du, Shuang Xia Duan, He Lu Cao, Yu Qian Zhao, Yun Yong Liu, Juan Xiu Huang, Ji Cao, Yan Ping Fan, Chang Yan Feng, Xue Mei Lian, Jing Chang Du, Remila Rezhake*Li Ma*, You Lin Qiao*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

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.

Original languageEnglish
Article number1168078
JournalFrontiers in Oncology
Volume13
DOIs
Publication statusPublished - 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
Copyright © 2023 Gu, Xu, Liu, Li, Yu, Zhang, Wang, Wang, Du, Duan, Cao, Zhao, Liu, Huang, Cao, Fan, Feng, Lian, Du, Rezhake, Ma and Qiao.

Keywords

  • China
  • colorectal cancer
  • decision making
  • self-reported efficacy
  • treatment

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