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Psychological factors and prognostic communication preferences in advanced cancer: multicentre study
  1. Avinash Ramchandani1,
  2. Luka Mihic-Góngora2,
  3. Raquel Hernández3,
  4. Marta Zafra-Poves4,
  5. María M Muñoz5,
  6. Estrella Ferreira6,
  7. Patricia Cruz-Castellanos7,
  8. Ana Fernández-Montes8,
  9. Vilma Pacheco-Barcia9,
  10. Paula Jiménez-Fonseca10 and
  11. Caterina Calderon6
  1. 1Department of Medical Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
  2. 2Department of Medical Oncology, Hospital Universitario Central de Asturias, Instituto de Investigación del Principado de Asturias, ISPA, Oviedo, Spain
  3. 3Department of Medical Oncology, Hospital Universitario de Canarias, La Laguna, Canarias, Spain
  4. 4Department of Medical Oncology, Hospital General Universitario José M Morales Meseguer, Murcia, Spain
  5. 5Department of Medical Oncology, Hospital General Virgen de la Luz, Cuenca, Spain
  6. 6Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
  7. 7Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
  8. 8Department of Medical Oncology, Complejo Hospitalario de Orense, Ourense, Galicia, Spain
  9. 9Department of Medical Oncology, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
  10. 10Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  1. Correspondence to Caterina Calderon, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona 08007, Spain; ccalderon{at}


Objectives Communication regarding prognosis to patients with advanced cancer is fundamental for informed medical decision making. Our objective was to analyse (1) the proportion of subjects with advanced cancer who prefer to know their prognosis, (2) the characteristics associated with patients’ preference for prognostic information, (3) the psychological factors that impact the preference to know prognosis and 4) the concordance between preference for prognostic information perceived among physicians and patients.

Methods A prospective, cross-sectional design was adopted. Data were collected from 748 participants with advanced cancer at 15 tertiary hospitals in Spain. Participants completed the following questionnaires: Mental Adjustment to Cancer; Trust in the Physician; Uncertainty in Illness Scale Patient’s Prognostic Preferences.

Results Fifty-two per cent of advanced cancer sufferers preferred to know the prognosis of their disease. Compared with participants who preferred not to know, those who did reported more uncertainty, greater satisfaction with their physician and higher scores on positive attitude (all p=0.001). Thirty-seven per cent of the physicians believed that patients want to know their prognosis, indicating that they underestimate the number of such patients. No significant differences were found regarding preference to know prognosis as a function of sociodemographic and clinical variables.

Conclusions A substantial proportion of individuals with advanced cancer prefer to know the prognosis of their disease. It appears that knowing their prognosis was mainly motivated by a need to maintain a positive attitude, lessen uncertainty and by satisfaction with the physician. It is important to explore patients’ preferences for information to offer more personalised communication.

  • prognosis
  • communication
  • cancer
  • clinical decisions
  • psychological care

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors AR, PJ-F and CC contributed equally to this work and coordinated the project. They conducted the database search; screened and extracted the data and wrote the first draft. All authors have made substantial contributions to the conceptualisation of the work; data collection, analysis and interpretation and approved the final version to be published. PJ-F and CC act as guarantors of the research.

  • Funding This study was funded by the FSEOM (Spanish Society of Medical Oncology Foundation) grant for Projects of the Collaborative Groups in 2018 and by an Astra Zeneca grant (ES2020-1939).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.