Cancer diagnosis and treatment: communication accuracy between patients and their physicians

We evaluated a patient's understanding of his or her cancer (diagnosis, location, stage, status) as a function of age, race, education, income, and marital status.

Patients with cancer were prospectively recruited and surveyed during their outpatient chemotherapy. Survey questions related to demographics, cancer status, location of cancer, stage of disease, prescribed treatment, the treating oncologist, and satisfaction with both the oncologist and medical staff. Each patient's answers to the survey questions were then compared with his or her medical chart. Data analysis was performed with the Chi-square test, logistic regression, and multivariate analysis.

Study participants included 284 patients (38% male, 62% female) (56% African American, 42% Caucasian, 3% others) with a median age of 62 years. Patients correctly answered in regards to their diagnosis (98%), cancer location (91%), and name of their doctor (99%). However, only 23% scored correctly when asked the stage of their cancer. In univariate analysis, younger age (P = 0.006) was the only significant variable in answering the question correctly, while higher income (P = 0.065) and female gender (P = 0.092) approached statistical significance. In multivariate analysis, all three variables were shown to be significant (P values of 0.016, 0.028, and 0.041, respectively). Increasing age resulted in a reduction of 2.5% per year, higher income resulted in an increase of 1.3% per 1000 dollars, and females were 49% more accurate, in the ability to correctly identify the cancer stage.

Although patients seem to know their condition well, many of them do not understand the stage of their cancer. Older patients, patients with lower income, and male patients seem to have less understanding of the stage of their cancer.