Abstract
Internet-based health education has been increasingly integrated into perioperative and postoperative management for patients with colorectal cancer (CRC). However, the overall effectiveness of such interventions on psychological well-being and recovery outcomes remains uncertain. A systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases from inception to December 2024. Eligible studies included randomized controlled trials (RCTs) or cohort studies evaluating Internet-based health education interventions in CRC patients, with control groups receiving conventional care or standard education. Primary outcomes were SAS (Self-Rating Anxiety Scale) and SDS (Self-Rating Depression Scale), and 36-Item Short Form Health Survey quality of life (QOL); secondary outcomes included postoperative recovery indicators such as time to first flatus and length of hospital stay. Data were pooled using random-effects meta-analyses, and heterogeneity was assessed using the I² statistic. A total of 20 studies (19 RCTs and 1 cohort study) involving 1540 participants were included. Meta-analysis showed that Internet-based health education methods can significantly improve self-care skills (SMD = 2.62, 95%CI: 0.25 ~ 4.99, P = 0.03), significantly reduce SAS (SMD= -0.97, 95%CI: -1.11~-0.83, P < 0.01) and SDS scores (SMD= -2.08, 95%CI: -3.54~-0.63, P = 0.01), reduce the incidence of postoperative complications (Log(OR)= -1.08, 95%CI: -1.45~-0.72, P < 0.01), and significantly improve QOL scores (SMD = 0.51, 95%CI: 0.29 ~ 0.72, P < 0.01). Considerable heterogeneity was observed in some analyses (I² > 90%). Subgroup analysis showed that the intervention method based on the WeChat platform was more effective in improving SAS (SMD= -1.06, P < 0.01). Internet-based health education, especially interactive and feedback-driven interventions delivered via mobile platforms, could effectively improve recovery outcomes among CRC patients in the perioperative and follow-up phases. Future studies should employ multicenter, long-term RCTs to verify sustainability, optimize intervention components, and assess cost-effectiveness.