Abstract
Background
Disclosing diagnosis to lung cancer patients is a critical issue. The psychosocial consequences of diagnostic awareness and its impact on life expectancy are issues of curiosity. We intended to evaluate the effects of diagnostic awareness on psychosocial symptomatology and survival time in advanced lung cancer patients.
Methods
This prospective cohort study was conducted on 126 advanced lung cancer patients admitted to the oncology department between Feb 2016 and Aug 2021. A face-to-face survey, including questions on age, gender, marital/employment statuses, comorbidities, and symptom checklist (SCL-90-R) assessment, was applied to patients. Diagnostic awareness was recorded by asking patients about comorbidities and obtaining confirmation from their relatives. Survival data was collected from the national death notification system on Feb 2023, and survival time was calculated from admission until Feb 2023.
Results
Of the patients, 104 were males, and 86 were non-survivors. Survival time and scores of SCL-90-R subscale dimensions were compared between diagnosis-aware (79.4%) and diagnosis-unaware groups (20.6%). Somatization, depression, psychoticism, additional scales, general symptoms, Positive Symptom Total, and Positive Symptom Distress Index scores were significantly higher in the diagnosis-unaware group (p=0.00, p=0.01, p=0.01, p=0.00, p=0.01, p=0.02, p=0.01, respectively). No significant associations were found between survival time and diagnostic awareness, gender, and marital/employment statuses.
Conclusions
Advanced lung cancer patients aware of such a serious disease experienced less psychosocial burden. However, no significant difference was found in survival time between diagnosis-aware and diagnosis-unaware patients. The diagnosis should be disclosed to lung cancer patients after the confirmation of diagnosis.