| Objective: Colorectal cancer is a common malignant tumor type in the digestive system.It is the third most common cancer in the world,the second cause of cancer death,and the third and fifth in the order of incidence and death respectively in China.It poses a serious threat to the life and health of the people and brings great medical burden.Therefore,to explore the current status of standardized diagnosis and treatment of colorectal cancer in Liaoning Province and analyze the influencing factors of standardized diagnosis and treatment are still of great significance for promoting the standardization of cancer.Methods: This study is a cross-sectional study,which collected the clinical data of 1015 colorectal cancer patients with different types and levels in Shenyang,Dalian,Jinzhou,Benxi,Anshan and Huludao and other representative cities through cluster sampling.To evaluate the standard diagnosis and treatment of colorectal cancer patients and understand the status quo of standardized diagnosis and treatment of colorectal cancer patients in Liaoning province according to the staging criteria of the eighth edition of the Cancer Staging Manual of the American Cancer Council and the Diagnosis and Treatment Guidelines for Colorectal Cancer in China(2017)issued by the Oncology Branch of the Chinese Medical Association.To explore the main problems of standardized diagnosis and standardized treatment in clinical practice.The status of standardized diagnosis and treatment of colorectal cancer in Liaoning Province was revealed by descriptive statistics.Chi-square test was used to screen the single factor that had statistical difference with standard diagnosis and standard treatment.Logistic regression model was used to analyze the independent influencing factors of standard diagnosis and standard treatment.Test level α = 0.05.Results: A total of 1015 patients were included and analyzed in this study,among which888 were diagnosed and treated with a standard diagnosis rate of 87.5% and 614 were treated with a standard treatment rate of 39.5%.Univariate analysis showed that Tumor location,TNM(primary tumor,regional lymph Node,distant Metastasis)staging and hospital type are correlated with standard diagnosis(P < 0.05).Family history of tumor,tumor location,remote medical treatment,gross type,tissue type,histological grade,TNM stage,and standard diagnosis were correlated with standard treatment(P < 0.05).Multivariate Logistic regression model analysis showed that tumor location,stage and hospital type were independent factors influencing standard diagnosis(P < 0.05).Single colon(OR = 3.427,95%CI: 1.055-11.125)and rectal(OR = 4.069,95%CI: 1.166-12.647)tumors were more likely to be standardized for diagnosis than mixed colorectal tumors(P< 0.05).Compared with stage Ⅳ,stage Ⅰ(OR = 83.670,95%CI: 23.786-294.322),stageⅡ(OR = 10.893,95%CI: 6.071-19.546)and stage Ⅲ(OR = 16.172,95%CI:8.547-30.599)the probability of standardized diagnosis is higher.The likelihood of standardized diagnosis was lower in unaffiliated hospitals than in affiliated hospitals(OR= 0.344,95%CI: 0.175-0.678).Under the premise of diagnostic criteria,family history of tumor,remote medical treatment,general type and stage were independent influencing factors for standardized treatment(P < 0.05).Patients with a family history of cancer were more likely to receive standardized care than those without a family history(OR = 21.128,95%CI:6.893-64.762);Patients treated in remote locations were more likely to receive standardized care than those treated in non-remote locations(OR = 1.977,95%CI:1.231-3.175);Patients with invasive tumors were less likely to receive standard treatment than those with ulcerative tumors(OR = 0.245,95%CI: 0.227-0.595).Compared with stage IV tumor patients,patients with stage Ⅰ(OR = 74.335,95%CI: 14.259-387.720)and stage Ⅱ low-risk tumor patients(OR = 17.489,95%CI: 6.265-48.818)were more likely to receive standard treatment.Patients with stage II high-risk factor tumors(OR = 0.240,95%CI: 0.092-0.629)were less likely to receive standard treatment.Conclusion:1.In the diagnosis and treatment of colorectal cancer,the phenomenon of non-standard diagnosis and treatment exists.In Liaoning Province,the diagnostic standard rate of colorectal cancer is 87.5%,and the treatment standard rate is 60.5%.2.The main problem of non-standard diagnosis is wrong TNM staging;The main problem of non-standard treatment is the insufficient level of chemotherapy for stage Ⅱhigh-risk factors-stage Ⅳ patients.3.Different types of hospitals have different levels of standardized diagnosis.4.Patients’ long-distance medical treatment behavior and their own clinical characteristics will affect the standard treatment. |
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