Key Skin Cancer Terms Not Understood by Almost 1/3 of Patients Surveyed

New data suggest many dermatology patients do not understand commonly-used skin-cancer–related terms and phrases, with the youngest age cohort scoring significantly lower than older individuals.1

Juna Khang, BA, from the department of dermatology at Beth Israel Deaconess Medical Center, led a team of investigators in authoring this analysis of survey data. Khang et al had sought to explore patient comprehension of cutaneous oncology-related terms, factors impacting understanding, and other related factors.

In this study, the team of investigators highlighted the importance of communicating with patients in dermatology settings with regard to skin cancer-related concerns.2

“Effective patient-physician communication is essential to quality health care and impacts health outcomes,” Khang and colleagues wrote.1,2 “This survey study aimed to assess patient understanding of commonly used cutaneous oncology-related words and phrases and identify factors that influence comprehension.”

Design and Notable Findings

The investigators provided an anonymous, voluntary questionnaire to patients at Beth Israel Deaconess Medical Center's general dermatology clinics. This took place during a 2-week timeframe in May 2025. Those who took part in the questionnaire provided demographic information and filled out a series of multiple-choice inquiries designed to assess their awareness of 13 often-used terms related to skin cancer.

In this survey, each question offered only a single correct answer. Those who were visiting for cosmetic concerns, those with cognitive impairment, and those who required interpreter services were not included in Khang et al's analysis. The investigators sought to explore the connection between demographic data and overall comprehension among patients, represented by the mean percentage of correct responses. To do this, they performed multivariable linear regression adjusted for all demographic variables. They defined statistical significance as P < .05.

Overall, Khang and coauthors' survey results revealed considerable variation in patients’ familiarity with widely-used terminology used to describe skin cancer and skin cancer management. The questionnaire concentrated primarily on neoplasm-related vocabulary and terms related to diagnostic or therapeutic procedures, so the analysis was unable to capture understanding of language related to inflammatory skin diseases. However, the survey's narrower scope allowed Khang and colleagues to explore specific gaps in skin cancer awareness.

Specifically, among the 182 individuals who met the survey's criteria for eligibility, 166 filled out the full survey. This reflected a 90.4% response rate. Among those who did so, 54.8% were women, 44.6% were men, and 1 subjects identified as nonbinary (0.6%). Scores on patients' comprehension showed significant differences across demographic cohorts. Looking at adults aged 60 years or older, individuals between 18 - 29 years demonstrated significantly poorer performance by comparison, with a β coefficient of –17.88 (95% CI, –28.37 to –7.39; P < .001).

Additionally, Khang et al found participants who held graduate-level degrees and those with more than 5 previous dermatology appointments attained the best scores. Specific term awareness was also shown to have varied widely. Nearly all respondent (95.0%) were correctly able to point to the definitions of “skin biopsy” and “topical.” In contrast, however, only 13.6% were aware of the meaning of “actinic."

21.6% were shown to have recognized the definition of “dysplastic nevus.” Roughly 61.1% understood “pathology results,” and 64.2% were able to accurately define “clear margins.” Most of those who responded to the survey successfully recognized basal cell carcinoma (69.9%), melanoma (82.2%), and squamous cell carcinoma (59.4%) as types of skin cancer. However, Khang and colleagues did highlight some of the more notable limitations of their survey and analysis of the results.

Given the number of respondents identifying as Black, Asian, multiracial, or Hispanic/Latino was small, the analysis could not draw reliable conclusions about distinctions specifically across these cohorts of patients. They also highlighted the single-center setting and the general lack of information about factors such as family history or the underlying reason for each dermatology center interaction. The investigative team also highlighted the high level of overall comprehension compared to the general population, pointing to the relatively large proportion of health care workers in the greater Boston region.

“Future research should explore interventions to improve patient education and examine whether tailored language improves understanding and engagement in dermatologic care,” the investigative team concluded.1

References

1. Khang J, Karatas E, Brag K, et al. Patient Comprehension of Skin Cancer–Related Terminology. JAMA Dermatol. Published online December 10, 2025. doi:10.1001/jamadermatol.2025.4756.

2. Street RL Jr, Makoul G, Epstein RM, et al. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2009 Mar;74(3):295-301. doi: 10.1016/j.pec.2008.11.015. Epub 2009 Jan 15. PMID: 19150199.