Any progress in informed consenting for cancer treatment? Results from a cross sectional analysis at a comprehensive cancer center

J Cancer Res Clin Oncol. 2021 Jul;147(7):2117-2126. doi: 10.1007/s00432-020-03495-1. Epub 2021 Jan 9.

Abstract

Purpose: Informed consent is required prior to any medical procedure. In the context of cancer treatment, special efforts are needed to inform cancer patients properly about treatment, potential sequelae and alternative therapies. Little is known about the effectiveness of current informed consent strategies and patients' individual satisfaction. Given the heterogeneity in terms of age, education, sex and other factors, detailed understanding of patients' comprehension and perception is the basis for further optimization of the informed consent process, which was the aim of the current investigation.

Methods: Patients with a new cancer diagnosis and recent informed consent were asked to complete a questionnaire about satisfaction, comprehension, time management, physician-patient relationship and other items of the informed consent process. Patients were followed for 6 months and invited to complete a follow-up questionnaire.

Results: In total, 89 patients completed the first questionnaire and 52 the follow-up questionnaire. Subjective understanding was assumed high, however, this did not correlate with objective understanding. Age and education were identified as influencing factors for comprehension. 85% of the patients were satisfied with the information provided. A major gap was the information on alternative therapies. Moreover, not all patients perceived the consent dialog as such, and particularly the individual treatment intention partially remained unclear for some patients.

Conclusions: To ensure that informed consent is based on solid understanding, informed consenting must be patient-centered and consider the individual expectations, needs and abilities of cancer patients. Further studies are required to develop tailored informed consent strategies.

Keywords: Cancer; Comprehension; Decision-making; Informed consent; Oncology; Patient–doctor relationship.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cancer Care Facilities / organization & administration*
  • Communication*
  • Comprehension
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Informed Consent / standards*
  • Male
  • Middle Aged
  • Neoplasms / therapy*
  • Patient Satisfaction
  • Physician-Patient Relations*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Young Adult