随着中国血吸虫病消除，其在结直肠癌（CRC）发病机制中的作用已经减少。然而，在中国，血吸虫相关的CRC（SACRC）与非血吸虫相关CRC（NSACRC）的趋势、临床病理特征、手术治疗模式和预后仍不清楚。从长海医院病理学登记处（2001-2021）检索的数据中分析了中国CRC患者中SACRC的百分比趋势。比较了两组之间的临床病理特征、手术治疗模式和预后相关参数。进行了病无复发生存和总生存的多元Cox回归分析。共纳入31,153例CRC病例，其中823例（2.6％）为SACRC病例，30,330例（97.4％）为NSACRC病例。 SACRC病例的平均百分比从2001年至2021年持续下降，从3.8％下降到1.7％。与NSACRC组相比，SACRC组男性更多，诊断年龄更大，体重指数更低，症状更少；直肠癌、合并症、KRAS突变、多发性原发性CRC和伴发息肉的比率更高；淋巴结转移、远处转移、血管侵犯和肿瘤萌芽形成较少；术前放疗和化疗较少；切缘阳性和术后靶向治疗较多。在腹腔镜手术、姑息切除、扩大根治切除或造口方面，两组之间没有显着差异。此外，SACRC组的疾病无复发生存率不良，与NSACRC组相似的总生存率。在多元分析中，血吸虫病无法预测疾病无复发生存或总生存。我们医院的SACRC百分比（2.6％）非常低，过去二十年持续下降，这表明血吸虫病已不再是中国上海CRC的重要危险因素。 SACRC患者具有不同的临床病理、分子和治疗相关特征，并具有与NSACRC相似的生存率。版权所有©2023作者。由沃尔特斯-克鲁尔健康公司出版。

With the elimination of schistosomiasis in China, its role in the pathogenesis of colorectal cancer (CRC) has decreased. However, the trends, clinicopathological features, surgical treatment patterns, and prognosis of schistosomiasis-associated CRC (SACRC) versus non-schistosomiasis-associated CRC (NSACRC) in China remain unclear.The percentage trend of SACRC in CRC patients in China was analyzed using data retrieved from the Pathology Registry of Changhai Hospital (2001-2021). Clinicopathological characteristics, surgical treatment patterns, and prognosis-related parameters were compared between the two groups. Multivariate Cox regression analyses were performed for disease-free survival and overall survival.A total of 31,153 CRC cases were included, with 823 (2.6%) cases of SACRC and 30,330 (97.4%) cases of NSACRC. The average percentage of SACRC cases has decreased continuously from 3.8% to 1.7% (from 2001 to 2021). Compared with the NSACRC group, the SACRC group had more men, older age at diagnosis, lower body mass index, fewer symptoms; higher rates of rectal cancer, comorbidities, KRAS mutation, multiple primary CRC and concomitant polyps; less lymph node metastasis, distant metastasis, vascular invasion, and tumor budding; less preoperative radiotherapy and preoperative chemotherapy; and more positive resection margins and postoperative targeted therapy. There were no significant differences between the two groups regarding laparoscopic surgery, palliative resection, extended radical resection, or ostomy. Moreover, the SACRC group had adverse disease-free survival and similar overall survival compared with the NSACRC group. In multivariate analyses, Schistosomiasis was not an independent predictor of disease-free or overall survival.The percentage of SACRC in CRC (2.6%) in our hospital was very low, and it decreased continuously over the last two decades, indicating that schistosomiasis is no longer an important risk factor for CRC in Shanghai, China. Patients with SACRC have distinct clinicopathological, molecular, and treatment-related features and survival rates similar to those with NSACRC.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.