Systematic Screening of Advanced Cancer Patients' Curability Perception: A Longitudinal Analysis

Area of Science:

• Oncology
• Palliative Care
• Health Psychology

Background:

• Systematic screening of illness understanding is an innovative method to normalize discussions about sensitive topics.
• This approach helps identify patients with unmet information needs, particularly in advanced cancer care.
• Accurate perception of curability is crucial for patient decision-making and psychological well-being.

Purpose of the Study:

• To evaluate changes in the perception of curability among patients with advanced cancer over time.
• To identify predictors associated with misperceptions of curability in this patient population.

Main Methods:

• Universal electronic systematic screening of illness understanding was implemented using the Prognosis and Treatment Perception Questionnaire.
• Data from 432 patients with advanced solid tumors, including initial consultation and at least one follow-up within a year, were retrospectively reviewed.
• Multivariable analysis was used to determine predictors of inaccurate perception of curability.

Main Results:

• At initial and follow-up visits, only 34.0% and 36.8% of patients, respectively, accurately perceived their curability (P=0.3).
• Inaccurate perception was linked to Asian race (OR=3.08), greater well-being (OR=0.83), better sleep (OR=0.89), and lower fatigue, depression, anxiety, and financial distress.
• No significant improvement in accurate perception of curability was observed between the initial and follow-up visits.

Conclusions:

• A significant majority of advanced cancer patients lack an accurate understanding of their curability, with little change observed over time.
• Systematic screening offers a valuable opportunity to enhance patients' understanding of their illness.
• Improving illness understanding through systematic screening can potentially enhance coping mechanisms and supportive care.