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Conceptualizing prognostic awareness in advanced cancer: A systematic review
Abstract
This systematic review synthesizes the complex literature on prognostic awareness in cancer. A total of 37 studies examining cancer patients’ understanding of their prognosis were included. Prognostic awareness definitions and assessment methods were inconsistent across studies. A surprisingly high percentage of patients (up to 75%) were unaware of their poor prognosis, and in several studies, even their cancer diagnosis (up to 96%), particularly in studies conducted outside of North America. This review highlights surprisingly low rates of prognostic awareness in patients with advanced cancer as well as discrepancies in prognostic awareness assessment, suggesting the need for empirically validated measures of prognostic awareness.
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“Applebaum and colleagues found that most studies simply asked patients with terminal illness whether they perceived the illness to be terminal or curable, or if the goal of treatment was palliative or curative.2”
From Measuring a Patient's understanding of their prognosis: An exploratory analysis (2022) · cites this paper as [2]
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“Additionally, given that many cancer patients do not have an accurate perception of their disease stage (Applebaum et al., 2014), stage of cancer as identified from medical charts might not be an appropriate proxy variable for patients’ understanding of their prognosis.”
From The relationship between acceptance of cancer and distress: A meta-analytic review (2019) · cites this paper as Applebaum et al., 2014
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Cited by
Sorted by citations
Optimism, social support, and mental health outcomes in patients with advanced cancer
Applebaum, A. J., Stein, E. M., Lord‐Bessen, J., Pessin, H., Rosenfeld, B. D., & BREITBART, W. S. (2013) · Psycho-Oncology · doi:10.1002/pon.3418 · Cited by 259
Self-citationChen, C. H., Kuo, S. C., & Tang, S. T. (2017) · Palliative Medicine · doi:10.1177/0269216316663976 · Cited by 146
The relationship between acceptance of cancer and distress: A meta-analytic review
Secinti, E., Tometich, D. B., Johns, S. A., & Mosher, C. E. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.05.001 · Cited by 132
“However, up to 75% of cancer patients do not have an accurate understanding of their disease stage or prognosis (Applebaum et al., 2014), which may, in part, reflect a lack of acceptance.”
BackgroundAdvance Care Planning in Serious Illness: A Narrative Review
Rosa, W. E., Izumi, S., Sullivan, D. R., Lakin, J. R., Rosenberg, A. R., Creutzfeldt, C. J., Lafond, D., Tjia, J., Cotter, V. T., Wallace, C. L., et al. (2022) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2022.08.012 · Cited by 129
Existential distress among caregivers of patients with brain tumors: a review of the literature
Applebaum, A. J., Kryza‐Lacombe, M., Buthorn, J. J., DeRosa, A. P., Corner, G., & Diamond, E. L. (2015) · Neuro-Oncology Practice · doi:10.1093/nop/npv060 · Cited by 111
Self-citation
Metadata
- Authors
- Applebaum, A. J., Kolva, E. A., Kulikowski, J. R., Jacobs, J. D., DeRosa, A., Lichtenthal, W. G., Olden, M. E., Rosenfeld, B., & Breitbart, W.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Fordham University (US)
- Weill Cornell Medicine (US)
- ORCID
- Venue
- Journal of Health Psychology
- Publisher
- SAGE Publications
- Published
- 2013-10-24
- Volume
- 19
- Issue
- 9
- Pages
- 1103-1119
- ISSN
- 1359-1053 (ISSN-L)
- 1461-7277
- PMC
- PMC4665620
- OpenAlex
- W2100410564
- Cited by
- 145
- References
- 66
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 14 · 2023: 19 · 2022: 13 · 2021: 14 · 2020: 12 · 2019: 13 · 2018: 12 · 2017: 6 · 2016: 6 · 2015: 5 · 2014: 3 · 2013: 1
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (NCI T32CA009461-28, R01CA128187, K07CA172216, P30CA008748, T32CA009461)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- prognostic awareness, advanced cancer, prognosis understanding, psychometric measures, end-of-life care
- MeSH terms
- Awareness, Humans, Neoplasms, Prognosis
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