Aries Budianto, Setyo Sugiharto, Dini Fildahlina
BACKGROUND: Colorectal cancer (CRC), a malignancy of the colon and rectum, is the second leading cause of cancerrelated deaths globally, following lung cancer. It accounts for 9.2% of global cancer mortality (880,792 deaths) and 10.2% of total cases (1,849,518). The 2020 GLOBOCAN survey ranks CRC third in incidence (19.5%) and mortality (9%). In Indonesia, CRC is the second most common cancer in men and fourth in women. Risk factors include non-sporadic factors (hereditary and familial) and sporadic factors (modifiable behaviors such as smoking and diet). This study examines the relationship between smoking habits and education level with CRC severity in East Java. METHODS: An observational, cross-sectional study was conducted on 172 colorectal adenocarcinoma patients from multiple East Java hospitals between February and April 2023. Data collection involved questionnaires and interviews, analyzed using Partial Least Square – Structural Equation Model (PLS-SEM) with WarpPLS software. RESULTS: Smoking showed a tendency to increase CRC severity, though the association was not statistically significant (P=0.21, coefficient=0.06). Education level exhibited a similar trend, with higher education strengthening the impact of smoking on CRC severity, but also not significantly (P=0.17, coefficient=0.07). CONCLUSIONS: While not statistically significant, smoking habits and lower education levels display a trend toward worsening CRC severity in East Java. This highlights the need for enhanced health education and smoking reduction interventions to mitigate CRC severity in the region. © 2025 EDIZIONI MINERVA MEDICA.
Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Brawijaya University, Malang, Indonesia; Department of General Surgery, Faculty of Medicine, Brawijaya University, Malang, Indonesia
