Attitude of cancer patients toward diagnosis disclosure and their preference for clinical decision-making: a national survey.
OBJECTIVE
There is still contradictory evidence on disclosure preferences regarding cancer diagnosis. The aim of this study was to evaluate the preference of cancer patients for knowing the truth about their disease, as well as the factors that might have an impact on these preferences.


METHODS
This study was conducted in 11 cancer centers in Iran. A questionnaire was used to collect data, and all patients above 15 years of age who were willing to participate were included in the study. The patients were asked if they were aware of the malignant nature of their disease, and if they came to know about their disease at the time of initial diagnosis, or later. The patients were then asked about the way they looked upon their disease. In the final part of the questionnaire, the participants were asked the level of involvement they prefer to have in making treatment decisions.


RESULTS
In total, 1226 patients were enrolled in this study, only 565 (46.7%) of whom were aware of their disease at the time of diagnosis, and 878 (72.7%) at the time of interview, while 980 (85.2%) were willing to receive information about their disease. Patients' awareness was significantly associated with age under 50 years, female gender, having breast, skin or head and neck cancer, and having medical care in Shiraz or Hamadan while it was not associated with the stage or accompanying illness.


CONCLUSIONS
While the majority of Iranian cancer patients prefer to be aware of the nature of their disease and have an active role in treatment decision making, they do not receive this information.
1)Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2)Radiation Oncology Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.18)National Program Director, Center for NON-COMMUNICABLE Disease, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran. agmotlagh@yahoo.com.
Ali
A
Motlagh
Sepas Organization, Tehran, Iran.
Neda
N
Yaraei
Radiation Oncology Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ahmad R
AR
Mafi
Radiation Oncology Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Farnaz
F
Hosseini Kamal
Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran.
Mehdi
M
Yaseri
Radiation Oncology Department, Seyed-ol-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Simin
S
Hemati
Radiation Oncology Department, Golestan Hospital, Ahvaz University of Medical Sciences, Ahvaz, Iran.
Hojatollah
H
Shahbazian
Mahdiye Oncology Center, Hamedan, Iran.
Abdol-Azim
AA
Sedighi
Radiation Oncology Department, Fayazbakhsh Hospital, Tehran, Iran.
Reza
R
Khodabakhshi
Radiation Oncology Department, Omid Hospital, Mashad University of Medical Sciences, Mashad, Iran.
Ali
A
Taghizadeh
Radiation Oncology Department, Khansari Hospital, Arak, Iran.
Jamshid
J
Ansari
Radiation Oncology Department, Imam Khomeini Hospital, Tabriz, Iran.
Farshad
F
Seyednejad
Radiation Oncology Department, Shafa Hospital, Gorgan, Iran.
Reza
R
Khanduzi
Radiation Oncology Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Khosro
K
Mojir Sheibani
Radiation Oncology Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Payam
P
Azadeh
Shahid Rajaei Oncology Center, Babolsar, Iran.
Mohamad Hasan
MH
Emranpour
Radiation Oncology Department, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Ahmad
A
Mosalei
Radiation Oncology Department, Khansari Hospital, Arak, Iran.
Soheil
S
Vojdani
Tarbiat Moalem University, Tehran, Iran.
Ali Mohamad
AM
Nazari
Jahad Daneshgahi, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Leila
L
Nazarimenesh
Iranian Cancer Society, Tehran, Iran.
Abdolah
A
Fazl-Alizadeh
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohamad Esmaeil
ME
Akbari
D000367:Age Factors; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000523:psychology; D010353:Patient Education as Topic; D010358:Patient Participation; D057240:Patient Preference; D011379:Prognosis; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014342:Truth Disclosure