title: Colorectal cancer concealment predicts a poor survival: a retrospective study.
abstract: OBJECTIVE
  Understanding the situation of cancer awareness which doctors give to patients might lead to prognostic prediction in cases of of colorectal cancer (CRC).
  
  
  METHODS
  Subsets of 10,779 CRC patients were used to 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 regression analysis. 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 of the 4,561 patients with cancer awareness survived, whereas 2,258 of the 5,469 patients without cancer awareness and 406 of the 749 patients without information on cancer awareness died of the disease. All-cause and cancer- specific survival were poorer for the patients without cancer awareness than those with (P < 0.001 for each, log- rank test). Cox multivariate regression analysis showed that cancer concealment cases had significantly lower cancer-specific survival (hazard ratio (HR) = 1.299; 95 % confidence interval (CI): 1.200-1.407)and all-cause survival (HR = 1.324; 95 % CI: 1.227-1.428). Furthermore, attitudes of cancer awareness between doctors and patients were significantly different (P < 0.001).
  
  
  CONCLUSIONS
  Cancer concealment, not only late-stage tumor and age, is associated with a poor survival of CRC patients.
authors.affiliation: Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China. sunqiao163@hotmail.com
authors.forename: Xiao-Pan
authors.initials: XP
authors.lastname: Li
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: Xie
authors.forename: Yi-Fei
authors.initials: YF
authors.lastname: Fu
authors.forename: Chen
authors.initials: C
authors.lastname: Yang
authors.forename: Li-Peng
authors.initials: LP
authors.lastname: Hao
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Yang
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Zhang
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Li
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Feng
authors.forename: Bei
authors.initials: B
authors.lastname: Yan
authors.forename: Qiao
authors.initials: Q
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D057210:Delayed Diagnosis / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013997:Time Factors; D014342:Truth Disclosure; D055815:Young Adult