{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T22:12:03Z","timestamp":1778796723596,"version":"3.51.4"},"reference-count":69,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["LYY22H310016"],"award-info":[{"award-number":["LYY22H310016"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Probiotics have become increasingly popular among cancer patients. However, there is limited data from a real-world setting. This study aims to conduct a retrospective analysis to understand the trend of probiotic prescriptions in Chinese colorectal cancer patients. The Mann-Kendall and Cochran-Armitage trend test was applied to estimate the trend significance. Gephi software identified the combination of probiotic strains. The binary logistic regression investigated influence factors, and Spearman\u2019s rank correlation coefficient calculated correlations between probiotics and antitumor drug usage. The probiotic prescription percentage increased from 3.3% in 2015 to 4.2% in 2021 (Z = 12.77, <jats:italic>p<\/jats:italic> &lt; 0.001). Although 48.3% of probiotic prescriptions had no indication-related diagnosis, diarrhea (OR 10.91, 95% CI 10.57\u201311.26) and dyspepsia (3.97, 3.82\u20134.12) included prescriptions most likely to contain probiotics. Prescriptions from the tertiary hospital (1.43,1.36\u20131.50), clinics (1.30, 1.28\u20131.33), and senior patients (1.018 per year, 1.017\u20131.019) were more likely to contain probiotics. Most probiotic prescriptions (95.0%) contained one probiotic product but multiple strains (69.3%). <jats:italic>Enterococcus faecalis<\/jats:italic> (49.7%), <jats:italic>Lactobacillus acidophilus<\/jats:italic> (39.4%), and <jats:italic>Clostridium butyricum<\/jats:italic> (27.9%) were the most prescribed strains. The probiotics co-prescribed with antitumor agents increased rapidly from 6.6% to 13.8% in seven years (Z = 15.31, <jats:italic>p<\/jats:italic> &lt; 0.001). Oral fluorouracil agents (2.35, 2.14\u20132.59), regorafenib (1.70,1.27\u20132.26), and irinotecan (1.27,1.15\u20131.41) had a higher probability to co-prescribed with probiotics. There was no correlation between probiotic strain selection and specific antitumor drug use. The increasing prescription of probiotics in colorectal cancer patients in China may be related to treating the gastrointestinal toxicity of anti-cancer drugs. With unapproved indications and a lack of strain selectivity, evidence-based guidelines are urgently needed to improve probiotic use in this population.<\/jats:p>","DOI":"10.1371\/journal.pone.0291864","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T17:44:21Z","timestamp":1695318261000},"page":"e0291864","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence and influencing factors of probiotic usage among colorectal cancer patients in China: A national database study"],"prefix":"10.1371","volume":"18","author":[{"given":"Difei","family":"Yao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangmin","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5768-2714","authenticated-orcid":true,"given":"Haibin","family":"Dai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,9,21]]},"reference":[{"issue":"3","key":"pone.0291864.ref001","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA: a cancer journal for clinicians"},{"issue":"6","key":"pone.0291864.ref002","first-page":"394","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"F Bray","year":"2018","journal-title":"CA: a cancer journal for clinicians"},{"issue":"11","key":"pone.0291864.ref003","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1002\/ijc.30382","article-title":"A global view on cancer incidence and national levels of the human development index","volume":"139","author":"MM Fidler","year":"2016","journal-title":"Int J Cancer"},{"issue":"8","key":"pone.0291864.ref004","first-page":"561","article-title":"Chinese protocol of diagnosis and treatment of colorectal cancer (2020 edition)","volume":"58","author":"Hospital Authority of National Health Commission of the People\u2019s Republic of China; Chinese Society of Oncology CMA","year":"2020","journal-title":"Chinese Journal of Surgery"},{"issue":"4","key":"pone.0291864.ref005","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1136\/gutjnl-2015-310912","article-title":"Global patterns and trends in colorectal cancer incidence and mortality","volume":"66","author":"M Arnold","year":"2017","journal-title":"Gut"},{"issue":"11","key":"pone.0291864.ref006","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1038\/s41575-019-0209-8","article-title":"Gut microbiota in colorectal cancer: mechanisms of action and clinical applications","volume":"16","author":"SH Wong","year":"2019","journal-title":"Nature reviews Gastroenterology & hepatology"},{"issue":"7792","key":"pone.0291864.ref007","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1038\/d41586-020-00199-x","article-title":"Fighting cancer with microbes","volume":"577","author":"E. 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