# Exploring perceptual disparities: A study on the level of understanding of colorectal cancer care among patients and healthcare professionals

## TL;DR

This study shows that patients and healthcare professionals often have different views on colorectal cancer, especially in palliative care, which can affect patients' mental health.

## Contribution

The study identifies significant perceptual disparities between patients and HCPs in colorectal cancer care, particularly in palliative settings.

## Key findings

- Significant differences in perception were observed between HCPs and patients, especially for those with progressing disease.
- Patients in palliative care showed the largest discrepancies in perception compared to HCPs.
- Patients perceiving disease progression had higher depression levels than those feeling their disease was under control.

## Abstract

Emotional engagement, family support and personal beliefs can influence how patients and healthcare professionals (HCPs) perceive cancer differently. This study examined the extent to which the views of patients and HCPs on cancer care align, and identified factors that may underlie disparities.

Participants with colorectal cancer (CRC) were asked to describe their perception of their disease (i.e. whether they felt it was under control (DC), was progressing (PD), or was of an unknown status) and to complete psychometric assessments of anxiety, depression, PTSD and well-being. Two HCPs, who were blinded to the patients’ responses, examined the case files to determine the stage of treatment at which the patients were enrolled in the study. The concordance of perceptions between patients and HCPs was examined, along with associations with clinical variables and psychometric health outcomes, using both univariate and multivariate analyses.

A total of 205 patients with CRC were included in the study. The mean age was 65 years, with 58% of patients being male. Overall, a significant difference in perception was observed between HCPs and patients (p < 0.001), particularly for patients identified by HCPs as having PD. Significant discrepancies were observed among patients receiving palliative care (p < 0.001), whereas those in the adjuvant or neo-adjuvant pathway appeared to align more closely with HCPs’ perceptions (p = 0.99). Neither demographic nor psychological factors were significant determinants of concordance between HCPs and patients’ understanding of cancer status in this population. In multivariate analysis, patients perceiving PD or expressing uncertainty were found to have significantly higher levels of depression than those with DC (OR 6.42, p = 0.001 and OR 3.86, p = 0.009, respectively).

This study reveals significant differences in how cancer is perceived by HCPs and patients, particularly among those without disease control or undergoing palliative care. This highlights the importance of effective communication in addressing patients’ needs and their psychological well-being.

The online version contains supplementary material available at 10.1007/s00384-025-05064-9.