Table 2.
Disease knowledge, medical experience, and expenditure in patients with early-onset and late-onset colorectal cancer
| Overall (N = 4572) | EOCRC, < 50 years (N = 991) | LOCRC, ≥ 50 years (N = 3581) | P value | |
|---|---|---|---|---|
| Awareness of CRC risk factors, yes | 1591 (34.9) | 366 (37.1) | 1225 (34.3) | 0.107 |
| Awareness of CRC screening, yes | 689 (15.1) | 169 (17.1) | 520 (14.6) | 0.055 |
| Awareness of CRC treatment, yes | 2019 (44.2) | 441 (44.5) | 1578 (44.1) | 0.827 |
| Undergoing the colonoscopy before the first diagnosis, yes | 120 (2.6) | 29 (2.9) | 91 (2.5) | 0.575 |
| Barriers to undergo colonoscopy | ||||
| Lack of awareness, yes | 3868 (87.0) | 834 (86.8) | 3034 (87.1) | 0.865 |
| No time for a colonoscopy, yes | 368 (8.3) | 93 (9.7) | 275 (7.9) | 0.087 |
| Heard that colonoscopy is a painful procedure, yes | 716 (16.1) | 141 (14.7) | 575 (16.5) | 0.189 |
| The cost of colonoscopy is high, yes | 172 (3.9) | 31 (3.2) | 141 (4.0) | 0.258 |
| Waiting in line for colonoscopy appointment, yes | 172 (3.9) | 42 (4.4) | 130 (3.7) | 0.414 |
| Insurance doesn’t cover it, yes | 97 (2.2) | 22 (2.3) | 75 (2.2) | 0.803 |
| Undergoing gene testing, including RAS, BRAF, and MSI, yes | 1974 (47.1) | 518 (56.7) | 1456 (44.4) | < 0.001 |
| Barriers to undergo gene testing | 0.052 | |||
| Target therapy is not accepted (other treatment options are considered to be sufficient) | 357 (16.1) | 45 (11.3) | 312 (17.2) | |
| The test is too expensive and not reimbursable | 528 (23.8) | 107 (26.8) | 421 (23.2) | |
| Anxious to receive treatment and unwilling to wait for genetic test results | 125 (5.6) | 18 (4.5) | 107 (5.9) | |
| Plan to blind-eat targeted drugs | 32 (1.4) | 6 (1.5) | 26 (1.4) | |
| Lack of knowledge | 952 (43.0) | 183 (45.9) | 769 (42.3) | |
| Others | 222 (10.0) | 40 (10.0) | 182 (10.0) | |
| RAS mutation, yes | 275 (32.5) | 59 (29.4) | 216 (33.5) | 0.301 |
| BRAF mutation, yes | 79 (9.3) | 23 (11.4) | 56 (8.7) | 0.266 |
| MSI, yes | 49 (5.8) | 13 (6.5) | 36 (5.6) | 0.608 |
| Undergoing the targeted therapy, yes | 1442 (31.7) | 364 (36.8) | 1078 (30.3) | < 0.001 |
| Barriers to undergo the targeted therapy | ||||
| The physician did not mention it to patients, yes | 1253 (40.4) | 266 (42.6) | 987 (39.8) | 0.231 |
| Genetic tests identify tumors that will not respond to targeted therapy, yes | 203 (6.5) | 40 (6.4) | 163 (6.6) | 0.944 |
| There is no confidence in the efficacy of these targeted drug treatments, yes | 703 (22.7) | 102 (16.3) | 601 (24.3) | < 0.001 |
| Cannot afford the cost of medical treatment, yes | 736 (23.7) | 143 (22.9) | 593 (23.9) | 0.618 |
| Treatments | ||||
| Surgery, yes | 3823 (83.8) | 836 (84.4) | 2987 (83.6) | 0.612 |
| Endoscopic treatment, yes | 141 (3.1) | 31 (3.1) | 110 (3.1) | 0.999 |
| Radiotherapy, yes | 1001 (21.9) | 266 (26.8) | 735 (20.6) | < 0.001 |
| Chemotherapy, yes | 3943 (86.4) | 906 (91.4) | 3037 (85.0) | < 0.001 |
| Immunotherapy, yes | 108 (2.4) | 24 (2.4) | 84 (2.4) | 0.992 |
| Out-of-pocket medical expenditure, Chinese Yuan | < 0.001 | |||
| < 50,000 | 1147 (25.2) | 187 (18.9) | 960 (26.9) | |
| 50,000-100,000 | 1859 (40.8) | 365 (36.9) | 1494 (41.8) | |
| 100,000-200,000 | 1040 (22.8) | 259 (26.2) | 781 (21.9) | |
| ≥ 200,000 | 514 (11.3) | 179 (18.1) | 335 (9.4) | |
| Medical expenditure reimbursement ratio (%) | 0.59 (0.18) | 0.56 (0.18) | 0.59 (0.18) | < 0.001 |
| Annual household income, Chinese Yuan | < 0.001 | |||
| None | 759 (16.7) | 106 (10.7) | 653 (18.3) | |
| < 50,000 | 1855 (40.7) | 353 (35.7) | 1502 (42.1) | |
| 50,000-100,000 | 1289 (28.3) | 309 (31.3) | 980 (27.5) | |
| 100,000-200,000 | 521 (11.4) | 163 (16.5) | 358 (10.0) | |
| ≥ 200,000 | 132 (2.9) | 57 (5.8) | 75 (2.1) | |
| Cost of colorectal cancer treatment from the perspective of patients | 0.413 | |||
| < 50,000 | 1314 (28.9) | 273 (27.7) | 1041 (29.2) | |
| 50,000-100,000 | 1510 (33.2) | 319 (32.3) | 1191 (33.5) | |
| 100,000-200,000 | 1103 (24.3) | 245 (24.8) | 858 (24.1) | |
| 200,000-500,000 | 524 (11.5) | 124 (12.6) | 400 (11.2) | |
| ≥ 500,000 | 96 (2.1) | 26 (2.6) | 70 (2.0) | |
| Health insurance | 0.005 | |||
| Urban basic medical insurance | 1919 (42.0) | 379 (38.2) | 1540 (43.0) | |
| Urban basic medical insurance | 981 (21.5) | 205 (20.7) | 776 (21.7) | |
| New rural cooperative medical scheme | 1552 (33.9) | 373 (37.6) | 1179 (32.9) | |
| Other | 120 (2.6) | 34 (3.4) | 86 (2.4) |
Abbreviations EOCRC, Early onset colorectal cancer; LOCRC, Late onset colorectal cancer; CRC, colorectal cancer; MSI, microsatellite instability
Values are presented as mean (standard deviations) for continuous variables or n (%) for categorical variables