Cancer patients' awareness about their diagnosis: a population-based study

Background The aim of the study was to evaluate Norwegian cancer patients' awareness of their prior cancer diagnosis in a general population-based study. Methods A cross-sectional population-based study of cancer patients' responses to the index question: 'Do you have or have you had cancer?' was carried out. We assessed correctness of the response in relation to cancer site, date of diagnosis, marital status, age and education. Smoking was chosen as a marker of health awareness. A total of 65330 persons participated in the Nord-Trondelag Health Survey (HUNT-II), performed in 1995-1997. The database of HUNT-II was merged with the Cancer Registry of Norway (CRN), thus identifying each of the 2983 (4 per cent) participants with an invasive cancer diagnosis. Results Excluding basal cell epithelioma, a total of 20 per cent of the patients denied their prior cancer diagnosis. This group consisted mainly of men (54 per cent) and those who were diagnosed as very young or as elderly. More smokers than non-smokers were unaware of their prior malignancy (24 per cent versus 20 per cent). Conclusions A 20 per cent rate of patients who denied their former malignancy is surprisingly and unacceptably high. Disclosure of a cancer diagnosis should help the patient to develop increased health awareness. It should enable a person to report his or her former cancer diagnosis when necessary.