title: The role of families in decisions regarding cancer treatments.
abstract: BACKGROUND
  Shared decision-making is an important component of patient-centered care and is associated with improved outcomes. To the authors' knowledge, little is known concerning the extent and predictors of the involvement of a patient's family in decisions regarding cancer treatments.
  
  
  METHODS
  The Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium is a large, multiregional, prospective cohort study of the cancer care and outcomes of patients with lung and colorectal cancer. Participants reported the roles of their families in decision-making regarding treatment. Multinomial logistic regression was used to assess patient factors associated with family roles in decisions.
  
  
  RESULTS
  Among 5284 patients, 80 (1.5%) reported family-controlled decisions, with the highest adjusted rates (12.8%) noted among non-English-speaking Asians. Among the 5204 remaining patients, 49.4% reported equally sharing decisions with family, 22.1% reported some family input, and 28.5% reported little family input. In adjusted analyses, patients who were married, female, older, and insured more often reported equally shared decisions with family (all P <.001). Adjusted family involvement varied by race/ethnicity and language, with Chinese-speaking Asian (59.8%) and Spanish-speaking Hispanic (54.8%) patients equally sharing decisions with family more often than white individuals (47.6%). Veterans Affairs patients were least likely to report sharing decisions with family, even after adjustment for marital status and social support (P <.001).
  
  
  CONCLUSIONS
  The majority of patients with newly diagnosed lung or colorectal cancer involve family members in treatment decisions. Non-English-speaking Asians and Hispanics rely significantly on family. Further studies are needed to determine the impact of family involvement in treatment decisions on outcomes; until then, physicians should consider eliciting patients' preferences for family involvement.
authors.affiliation: Department of Medical Oncology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Gabriela S
authors.initials: GS
authors.lastname: Hobbs
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Landrum
authors.forename: Neeraj K
authors.initials: NK
authors.lastname: Arora
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Michelle
authors.initials: M
authors.lastname: van Ryn
authors.forename: Jane C
authors.initials: JC
authors.lastname: Weeks
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Mack
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Keating
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000523:psychology / Q000628:therapy*; D003657:Decision Making; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology*; D017060:Patient Satisfaction; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult
keywords: cohort study; colorectal neoplasms; decision-making; lung neoplasms; professional-family relations; shared