title: Concealment of lung cancer diagnosis: prevalence and correlates.
abstract: BACKGROUND
  Lung cancer has a commonly understood behavioral etiology. Thus, lung cancer patients are often blamed for their illness and may seek to avoid this blame by concealing their diagnosis from others. This study sought to determine the prevalence of concealment and identify demographic, clinical, and psychosocial correlates of concealment among lung cancer patients.
  
  
  METHODS
  A sample of 117 lung cancer patients receiving chemotherapy for non-small cell or small cell lung cancer was recruited and completed self-report demographic questionnaires, a measure of diagnosis concealment designed and pilot tested for this study, and standard measures of psychosocial variables. Clinical factors were assessed via a medical chart review.
  
  
  RESULTS
  Thirty participants (26%) reported concealing their diagnosis in the previous month, most frequently from casual friends and close friends. Reported reasons for concealment largely reflected concern for others. Univariate analyses indicated that those who concealed their lung cancer diagnosis reported more internalized shame related to their illness and use of positive reappraisal as a coping strategy (ps ≤ 0.02). In addition, those who concealed were more likely to have used alcohol in the previous month and have a more recent recurrence, among those who had a recurrence (ps ≤ 0.04). Multivariate analyses indicated that internalized shame and use of positive reappraisal accounted for significant unique variance in concealment above and beyond that accounted for by use of alcohol (ps < 0.05).
  
  
  CONCLUSIONS
  Future research should aim to replicate and extend these findings with longitudinal designs to elucidate the directionality of the associations observed in this study.
authors.affiliation: Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Brian D
authors.identifier: http://orcid.org/0000-0001-5108-5735
authors.initials: BD
authors.lastname: Gonzalez
authors.affiliation: Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Heather S L
authors.initials: HS
authors.lastname: Jim
authors.affiliation: Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Cessna
authors.affiliation: School of Aging Studies, University of South Florida, Tampa, FL, USA.
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
authors.affiliation: Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Sutton
authors.affiliation: Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D055752:Small Cell Lung Carcinoma / Q000523:psychology*; D012938:Social Perception; D011795:Surveys and Questionnaires; D014342:Truth Disclosure