Standard pathology reports may be difficult to understand for patients with prostate cancer

Findings from a recent survey published in JAMA showed that most participants were unable to decipher basic information, including whether they have cancer, from standard prostate cancer pathology reports.^1,2

Reported worry was significantly linked to risk level in the PCPR cohort.

However, respondents who received a patient-centered pathology report (PCPR) were better able to comprehend diagnostic information and risk levels, indicating that tailored reports with plain language information may improve patient understanding.

“Pathologists can generate PCPRs as a supplement to their standard report using a template in a few minutes,” the authors wrote. “However, few studies of PCPRs exist, and no previous study has directly compared PCPRs with standard formats in current use.”

To that end, the investigators fielded an online survey to adult patients in the US who had a prostate and no history of prostate cancer. Participants were given a hypothetical scenario in which they had undergone a prostate biopsy and were receiving the associated pathology report.

In total, 2238 adults who met the inclusion criteria completed the survey and were included for analysis. Of those, 799 received the PCPR, 706 received a standard university pathology report, and 733 received a standard Veterans Affairs (VA) pathology report.

Overall, participants who received the PCPR were better able to identify if prostate cancer was present, their risk level, and their Gleason score.

Specifically, 93% of participants who received the PCPR were able to identify that they had prostate cancer, compared with only 39% of those who received the university report and 56% of those who received the VA report (P < .001).

Additionally, 93% of participants were able to accurately identify their risk level with the PCPR, compared with 41% of participants who received the university report and 36% of participants who received the VA report (P < .001). More specifically, in the PCPR cohort, 94.9% of participants in the low-risk scenario and 91.9% of participants in the high-risk scenario were able to correctly identify their risk level. In the university and VA arms, the risk level was correctly identified among 46.8% and 48.9% of participants in the low-risk scenario and 33% and 23.7% of participants in the high-risk scenario, respectively.

The findings also showed that 84% of participants who received the PCPR were able to identify the correct total Gleason score, compared with 48% of participants who received the university report and 40% of participants who received the VA report (P < .001).

In line with the finding that the PCPR led to a better understanding of risk, reported worry was significantly associated with risk level in these participants. Compared with participants in the standard arms, those in the PCPR cohort showed a lower level of worry in the low-risk scenario and a higher level of worry in the high-risk scenario (P < .001).

Specifically, in the PCPR group, the mean perceived worry was 2.86 (on a scale of 1 to 5) among patients in the low-risk scenario and 4.46 among participants in the high-risk scenario. In the university and VA cohorts, the mean perceived worry was 3.71 and 3.61 in the low-risk scenario and 3.90 and 3.79 in the high-risk scenario, respectively.

Overall, participants in the PCPR arm reported a significantly higher score for ease of understanding compared with those in the standard report groups (P < .001).

According to the authors, these findings support the use of PCPRs when communicating clinical information to patients.

“Hospital systems should consider including PCPRs with standard pathology reports to improve patient understanding,” they concluded.

References

1. Lapedis CJ, Kurnot SR, Bergholtz SE, et al. Knowledge and worry following review of standard vs patient-centered pathology reports. JAMA. 2025. doi:10.1001/jama.2024.25461

2. Knowledge and worry following review of standard vs patient-centered pathology reports. News release. JAMA Network. January 2, 2025. Accessed January 23, 2025. https://www.eurekalert.org/news-releases/1069211