Annals of Oncology Advance Access originally published online on March 21, 2006
Annals of Oncology 2006 17(5):853-859; doi:10.1093/annonc/mdl028
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© 2006 European Society for Medical Oncology
Diagnosis and prognosis disclosure among cancer patients. Results from an Italian mortality follow-back survey
1 Unit of Clinical Epidemiology, National Cancer Institute, Genova; 2 Psychology Service, National Cancer Institute, Genova; 3 Department of Epidemiology, National Cancer Institute, G.Pascale Foundation, Naples; 4 Agency for Public Health, Lazio Region, Rome; 5 Clinical Epidemiology, Centre for the Study and Prevention of Cancer, Florence; 6 Mental Health Department, S. Luigi Gonzaga Hospital, University of Turin, Italy
* Correspondence to: Dr M. Costantini, Unit of Clinical Epidemiology, National Cancer Institute, Largo R. Benzi, 10, 16132, Genoa, Italy. Tel: +39-010-5737482; Fax: +39-010-354103; E-mail: massimo.costantini{at}istge.it
Background: The observed cultural changes in truth-telling attitudes suggest a radical change in the practice of delivering information to cancer patients, but limited research is available from countries known for their policy of non-disclosure. This study estimates the proportion of Italian who died of cancer who had received information about diagnosis and prognosis, and explores the variables associated with disclosure.
Materials and methods: This is a mortality follow-back survey of 1271 non-professional caregivers of Italians who died of cancer in 2002, representative of the approximate 160 000 Italian annual cancer deaths. Caregivers were interviewed after the patient's death about the process of diagnosis and prognosis disclosure.
Results: It was estimated that 37% of people who died of cancer had received information about diagnosis and 13% about poor prognosis. A consistent proportion, although non-informed, knew the diagnosis (29%) and the poor prognosis (50%). The probability to be informed was higher for patients living in the north of Italy, young, well educated, with longer survival, and with breast or head and neck tumor.
Conclusions: These findings suggest that not necessarily the observed cultural changes towards a less paternalistic approach in medical care translate into an effective change in the quantity of information delivered to the patients.
Key words: cancer, diagnosis, disclosure, prognosis
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