Cancer Res Treat.  2016 Apr;48(2):759-767. 10.4143/crt.2015.124.

Terminal Versus Advanced Cancer: Do the General Population and Health Care Professionals Share a Common Language?

Affiliations
  • 1Department of Family Medicine and Cancer Survivorship Clinic, Seoul National University Hospital, Seoul, Korea. dwshin.snuh@gmail.com
  • 2Laboratory of Health Promotion and Health Behavior, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
  • 3National Cancer Control Institute, National Cancer Center, Goyang, Korea. jonghyock@gmail.com
  • 4Regional Cardiocerebrovascular Center, Chungbuk National University Hospital, Cheongju, Korea.
  • 5Cancer Policy Branch, National Cancer Center, Goyang, Korea.
  • 6Hospice and Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
  • 7Institute on Aging, Seoul National University College of Medicine, Seoul, Korea.
  • 8Advanced Institutes of Convergence Technology, Seoul National University, Suwon, Korea.
  • 9Department of Health Informatics and Management, College of Medicine, Chungbuk National University, Cheongju, Korea.
  • 10Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, Korea.

Abstract

PURPOSE
Many end-of-life care studies are based on the assumption that there is a shared definition of language concerning the stage of cancer. However, studies suggest that patients and their families often misperceive patients' cancer stages and prognoses. Discrimination between advanced cancer and terminal cancer is important because the treatment goals are different. In this study, we evaluated the understanding of the definition of advanced versus terminal cancer of the general population and determined associated socio-demographic factors.
MATERIALS AND METHODS
A total of 2,000 persons from the general population were systematically recruited. We used a clinical vignette of a hypothetical advanced breast cancer patient, but whose cancer was not considered terminal. After presenting the brief history of the case, we asked respondents to choose the correct cancer stage from a choice of early, advanced, terminal stage, and don't know. Multinomial logistic regression analysis was performed to determine sociodemographic factors associated with the correct response, as defined in terms of medical context.
RESULTS
Only 411 respondents (20.6%) chose "advanced," while most respondents (74.5%) chose "terminal stage" as the stage of the hypothetical patient, and a small proportion of respondents chose "early stage" (0.7%) or "don't know" (4.4%). Multinomial logistic regression analysis found no consistent or strong predictor.
CONCLUSION
A large proportion of the general population could not differentiate advanced cancer from terminal cancer. Continuous effort is required in order to establish common and shared definitions of the different cancer stages and to increase understanding of cancer staging for the general population.

Keyword

Advanced cancer; Terminal cancer; Neoplasms; General population; Shared decision; Language

MeSH Terms

Breast Neoplasms
Delivery of Health Care*
Discrimination (Psychology)
Humans
Logistic Models
Neoplasm Staging
Prognosis
Surveys and Questionnaires

Figure

  • Fig. 1. Distribution of public responses to the hypothetical advanced cancer case (n=2,000).


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J Korean Med Assoc. 2018;61(8):509-521.    doi: 10.5124/jkma.2018.61.8.509.

Experiences and Opinions Related to End-of-Life Discussion: From Oncologists' and Resident Physicians' Perspectives
Su-Jin Koh, Shinmi Kim, JinShil Kim, Bhumsuk Keam, Dae Seog Heo, Kyung Hee Lee, Bong-Seog Kim, Jee Hyun Kim, Hye Jung Chang, Sun Kyung Baek
Cancer Res Treat. 2018;50(2):614-623.    doi: 10.4143/crt.2016.446.


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