Diagnostic awareness, psychosocial symptoms, and survival time in patients with advanced lung cancer

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Abstract
Objective: Disclosing to patients the diagnosis of lung cancer is an issue, especially in the Middle East where cultural factors may prohibit disclosure from being done. The psychosocial consequences of diagnostic awareness and its impact on life expectancy is an important issue that may influence the disclosure decision. The present study evaluated the effects of diagnostic awareness on psychosocial symptomatology and survival time in patients with advanced lung cancer in Turkey. Methods: This prospective cohort study included 126 advanced lung cancer patients admitted to the oncology department between February 2021 and August 2021. A face-to-face survey included questions on age, gender, marital/employment statuses, comorbidities, and psychological symptoms (SCL-90-R). Diagnostic awareness was assessed by asking patients whether they knew their diagnosis. The correlation of diagnostic awareness with 2-year survival time was analyzed using Cox regression analysis. Results: Of the 126 patients, had 86 died at the time of follow-up. Survival time and scores on SCL-90-R symptom subscales were compared between diagnosis-aware (79.4%) and diagnosis-unaware groups (20.6%). Somatization ( P = 0.04), depression ( P = 0.01), hostility ( P = 0.03), scores on additional symptom scales ( P = 0.01), and symptom total scores ( P = 0.01) were significantly higher in the diagnosis-unaware group. No significant difference was found between diagnostic awareness and survival time ( P = 0.24). Conclusions: Advanced lung cancer patients aware of their diagnosis experienced less psychosocial burden. However, no significant difference was found in survival time between diagnosis-aware and diagnosis-unaware patients. These findings suggest that the diagnosis should be disclosed to lung cancer patients after confirmation.

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