Lay understanding of terms used in cancer consultations

The study assessed lay understanding of terms used by doctors during cancer consultations. Terms and phrases were selected from 50-videotaped consultations and included in a survey of 105 randomly selected people in a seaside resort. The questionnaire included scenarios containing potentially ambiguous diagnostic/prognostic terms, multiple-choice, comprehension questions and figures on which to locate body organs that could be affected by cancer. Respondents also rated how confident they were about their answers. About half the sample understood euphemisms for the metastatic spread of cancer e.g. 'seedlings' and 'spots in the liver' (44 and 55% respectively). Sixty-three per cent were aware that the term 'metastasis' meant that the cancer was spreading but only 52% understood that the phrase 'the tumour is progressing' was not good news. Yet respondents were fairly confident that they understood these terms. Knowledge of organ location varied. For example, 94% correctly identified the lungs but only 46% located the liver. The findings suggest that a substantial proportion of the lay public do not understand phrases often used in cancer consultations and that knowledge of basic anatomy cannot be assumed. Yet high confidence ratings indicate that asking if patients understand is likely to overestimate comprehension. Awareness of the unfamiliarity of the lay population with cancer-related terms could prompt further explanation in cancer-related consultations.