Journal scan

Cancer patients seeking second opinion due to 'lack of trust'

Review suggests more than one in four self-referral cases driven by 'negative motivations'

Review suggests more than one in four self-referral cases driven by 'negative motivations'

Picture: Alamy

Patients have cited a lack of trust as one reason for seeking a second opinion when diagnosed with cancer, a systematic review has found.

Further causes for requiring a second opinion were found to be ‘a need for certainty or confirmation, dissatisfaction with communication, and/or a need for more (personalized) information’.

The findings come from researchers at the department of medical psychology, academic medical center, University of Amsterdam, who analysed 25 studies between 1993 and 2015 from across the globe.

What might be perceived as negative motivations, such as a lack of trust or dissatisfaction with communication from the original oncologist was reported with a frequency of 27-31% in four studies. 

Other rationales included ‘requiring more information’ about treatment options (70%),‘concerns with care’ (13%), and encouragement by ‘close ones’ (9%).

The review found that rates of self-referral ranged from 1-88%; Taiwanese patients with colorectal cancer reported the highest rate and Japanese patients with oral cancer the lowest.

Higher academic attainment was the most consistent and frequent feature of second-opinion seeking behaviours. However, differences in gender, age or ethnicity were less consistently predictive across the various literature.

Results also found the rate of differences in agreement between the first and second opinions ranged between 2-51%.

Hillen MA, Medendorp NM, Daams JG et al (2017) Patient-driven second opinions in oncology: a systematic review. The Oncologist. 22, 10, 1197-1211.

Compiled by Dion Smyth, lecturer-practitioner in cancer and palliative care, Birmingham City University

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