# Attitudes and health behaviors of middle-aged and older adults with elevated tumor markers in China

## TL;DR

The study explores how middle-aged and older Chinese adults respond to elevated tumor marker test results and the factors influencing their health behaviors and attitudes.

## Contribution

This study identifies behavioral and psychological responses to elevated tumor markers in China and highlights the role of doctors in guiding patient decisions.

## Key findings

- Most participants felt stressed about elevated tumor markers and were unwilling to stop the tests.
- Health behaviors like lifestyle changes and seeking information were common after elevated results.
- Family history, education, and comorbidities influenced specific health behaviors and retesting decisions.

## Abstract

To understand the attitudes and health behaviors of middle-aged and older adults in China after receiving elevated results of tumor markers (TMs) test in the annual health examinations (AHEs) and explore the influencing factors.

A three-section online questionnaire survey was conducted from March 1 to April 30, 2020 in Hangzhou, China, to people who were aged 45 and older and had at least one elevated result of TMs test. Clinical information was collected from the online survey and medical records. Descriptive statistics were carried out followed by regression analyses.

Of 380 participants, 76.1% were unwilling to quit the TMs test in AHEs, whereas 75.3% would take the doctor’s advice and quit unnecessary TMs test; 67.4% felt stressed about their TMs. Among participants with elevated TMs, 76.8% changed lifestyle to keep healthy, 74.2% sought health information, 58.9% requested a TMs retest, and 50.3% did further tests to confirm a diagnosis. Family history of cancer was associated with lifestyle changing; education level, area of residence and health insurance were associated with health information seeking; comorbidity were associated with retests and sequential confirming tests.

The application of the TMs test in AHEs among Chinese people may lead to positive and negative behavioral consequences and psychological distress. Doctors have a significant impact on patients’ health behaviors. Accurate indications and adequate communication with patients before and after the TMs test are in great need.