Truth-Telling: A Comparative Analysis of Cancer Diagnosis Disclosure Protocols in Western and Eastern Countries

Abstract

In Western countries, a cancer diagnosis is nearly always discussed directly and immediately with the patient, whereas in Eastern countries, a patient may or may not be told of their disease and prognosis. The aim of this study was to compare the current protocols in place for disclosing a cancer diagnosis (CDD) across a number of countries in different regions of the world to better understand the causes for different practices. A narrative review of the literature was conducted with thirty articles reviewed and discussed. The findings from the review show that cancer diagnosis disclosure is a constantly evolving science. Truth-telling is a complex concept that involves a patient’s diagnosis, prognosis, treatment, side-effects, risks and benefits, quality of life and financial impact. This foundational perspective difference is what must be understood in order to make progress towards patient autonomy in cultures with strong family-centered values. Moreover, the study reveals that changing cultural stigmas about cancer through media education for the public as well as communication skills training for healthcare providers may help to bridge the gap.