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February 26, 2026Supportive Care in Cancer0 citationsOpen Access

Determining patient-oncologist cancer treatment intent concordance using systematic screening in a supportive care center

KAKayley M. Ancy SASujin Ann-YiThe University of Texas MD Anderson Cancer Center YHYi HuangThe University of Texas MD Anderson Cancer Center

Puntos clave

To determine agreement between patient-reported and oncologist-documented cancer treatment intent and its association with patient characteristics.
Implemented illness understanding screening in a supportive care center.
Compared patient responses on treatment goal and perceived chance of cure to oncologist documentation.
Analyzed data from 300 patients presenting for initial consultation.
50.7% of patients reported concordant treatment intent with oncologist documentation.
98.6% of patients with discordant intent inaccurately reported intent of cure.
Patients who were Black, had advanced disease, and reported lower spiritual pain were more likely to have discordant intent.

Resumen

Accurate illness understanding is a necessary component of goal-concordant care. Few prior studies have investigated systematic screening for illness understanding. The objectives of this study were to determine the extent of agreement between patient-reported and oncologist-documented cancer treatment intent using systematic screening and to explore the association between such agreement and patient characteristics. We implemented illness understanding screening for patients who presented to our supportive care center (SCC). We compared patient responses regarding chance of cure and primary treatment goal on a survey administered at their initial consultation visit with the oncologist-documented treatment intent in the electronic health record. The analysis included 300 patients (mean age, 59 years); most were women (56%), were White (80.3%), and had advanced disease (78%). Regarding concordance, 152 (50.7%) patients had concordant treatment intent (cure, n = 64; non-cure, n = 88), and 148 (49.3%) patients had discordant treatment intent, with 98.6% (n = 146) of patients with discordant treatment intent inaccurately reporting a treatment intent of cure. Patients with discordant treatment intent were more likely to be Black (OR = 3.13, p = 0.02), have a primary cancer site of “other” (mostly melanoma and sarcoma) (OR = 2.30, p = 0.04), have advanced disease (OR = 6.25, p < 0.001), and report lower spiritual pain (OR = 0.88, p = 0.04). The rate of inaccuracy in patient-reported curability perception and primary treatment goal at our SCC is high, supporting the need for systematic screening and communication interventions to improve illness understanding and provide goal-concordant care.

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