Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
McGill University Health Centre, Montreal, Canada.
Patient Educ Couns. 2024 Sep;126:108321. doi: 10.1016/j.pec.2024.108321. Epub 2024 May 23.
Patients diagnosed with low-risk lesions are confused about whether they have cancer, and experience similar anxiety to those with invasive cancer, which affects quality of life. Current labels for low-risk lesions were chosen by clinicians and lack meaning to patients.
We reviewed published research on preferred labels and language for low-risk lesions, and the rationale for those preferences.
Of 6569 titles screened, we included 13 studies. Among healthy adults with cervix or prostate lesions, use of the term "cancer" rather than "nodule" or "lesion" resulted in greater anxiety, higher perceived disease severity, and selection of more invasive treatment. Physicians asked about removing "carcinoma" from thyroid lesion labels to reduce patient anxiety and discourage over-treatment did not support this change, instead preferring a term that included "neoplasm".
This review revealed a startling paucity of research on preferences for low-risk lesion labels and language, and associated rationale. Future research is needed to understand how to improve communication about low-risk lesions.
To reduce anxiety and improve the overall well-being of patients, it is crucial to gain a deeper understanding of how to improve patient-provider conversations regarding screen-detected lesions with a low risk of developing into invasive cancer.
被诊断为低危病变的患者对自己是否患有癌症感到困惑，并且与患有浸润性癌症的患者一样感到焦虑，这会影响生活质量。目前低危病变的标签是由临床医生选择的，对患者来说没有意义。
我们回顾了已发表的关于低危病变首选标签和语言的研究，以及这些偏好的理由。
在 6569 篇标题筛选中，我们纳入了 13 项研究。在健康的宫颈或前列腺病变成年人中，使用“癌症”而不是“结节”或“病变”这两个术语会导致更大的焦虑、更高的疾病严重程度感知以及更具侵袭性的治疗选择。医生询问是否可以从甲状腺病变标签中删除“癌”以降低患者的焦虑并阻止过度治疗，但这一改变并没有得到支持，而是更倾向于使用包含“肿瘤”的术语。
本综述揭示了关于低危病变标签和语言偏好及其相关理由的研究惊人地匮乏。需要进一步研究来了解如何改善对低危病变的沟通。
为了降低焦虑并提高患者的整体幸福感，了解如何改善针对筛查出的低风险癌变可能性病变的医患对话至关重要。
