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Multicenter Study
. 2023 Jul 3:68:1606091.
doi: 10.3389/ijph.2023.1606091. eCollection 2023.

Real-World Utilization, Barriers, and Factors Associated With the Targeted Treatment of Metastatic Colorectal Cancer Patients in China: A Multi-Center, Hospital-Based Survey Study

Yin Liu  1 , Xi Zhang  2 , Hui-Fang Xu  1 , Ji-Hai Shi  3 , Yu-Qian Zhao  4 , Ling-Bin Du  5 , Yun-Yong Liu  6 , Wen-Jun Wang  7 , He-Lu Cao  8 , Li Ma  9 , Juan-Xiu Huang  10 , Ji Cao  11 , Li Li  12 , Yan-Ping Fan  13 , Xiao-Fen Gu  14 , Chang-Yan Feng  15 , Qian Zhu  16 , Xiao-Hui Wang  17 , Jing-Chang Du  18 , Jian-Gong Zhang  1 , Shao-Kai Zhang  1 , You-Lin Qiao  1   19
Affiliations
Multicenter Study

Real-World Utilization, Barriers, and Factors Associated With the Targeted Treatment of Metastatic Colorectal Cancer Patients in China: A Multi-Center, Hospital-Based Survey Study

Yin Liu et al. Int J Public Health. .

Abstract

Objectives: To explore the utilization, barriers, and factors associated with the targeted treatment of Chinese metastatic colorectal cancer (mCRC) patients. Methods: A total of 1,688 mCRC patients from 19 hospitals in 14 cities were enrolled from March 2020 to March 2021 using stratified, multistage cluster sampling. The use of targeted therapy and any barriers patients experienced were collected. Logistic regression analyses were conducted to identify the factors associated with initiating targeted treatment. Results: About 51.6% of the patients initiated targeted therapy, of whom 44.5%, 20.2%, and 35.2% started first-, second-, and third-line treatment, respectively. The most reported barriers were high medical costs and a lack of belief in the efficacy of targeted therapy. Patients treated in the general hospital, diagnosed at an older age, less educated, and who had a lower family income, no medical insurance, poor health-related quality of life, metastasis outside the liver/lung or systemic metastasis, a shorter duration of mCRC were less likely to initiate targeted therapy. Conclusion: Reduced medical costs and interventional education to improve public awareness could facilitate the use of targeted treatment for mCRC.

Keywords: associated factors; barriers; metastatic colorectal cancer; targeted treatment; utilization.

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Conflict of interest statement

The authors declare that they do not have any conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Framework of predisposing, enabling, and need factors for initiating targeted treatment. HRQOL, health-related quality of life; mCRC, metastatic colorectal cancer (China, 2023).
FIGURE 2
FIGURE 2
Distribution of the timing (first-line, second-line, and third-line) and kinds of targeted agents first used by metastatic CRC (mCRC) patients (China, 2023).
FIGURE 3
FIGURE 3
Barriers to the initiation of targeted therapy by metastatic CRC (mCRC) patients (China, 2023).
See this image and copyright information in PMC

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